Medical BillerJob Description, Salary, Career Path, and Trends

A medical biller manages the billing insurance and processing payments for clients. They prepare and submit claims for medical procedures and services provided to insurance companies, communicate with patients about outstanding balances, and collect payments for the provider institution. They must have good attention to detail and ensure that patient medical information is accurate and up to date. They must be able to analyze medical data and use sound judgment. Strong written and verbal communication skills are necessary to work with patients, clients, collection agencies, and insurance companies.

Medical billers monitor accounts, work with patients to develop payment arrangements, and pursue delinquent accounts. They need an in-depth understanding of billing software, electronic medical records, and medical codes. Excellent written and verbal communication skills are important, as well as solid problem-solving skills, good organizational skills, and the ability to work with numbers. Medical billers typically work in physician’s offices, hospitals, nursing homes, or other health care facilities.

Sample job description #1

Seeking an individual with medical billing and EMR billing software experience who strives to deliver the highest of customer service standards. This position is responsible for supporting the Account Management team by posting payments, capturing/working denials, and working outstanding accounts receivable (A/R) balances.

Major duties/responsibilities

  • Post all insurance payments, contractual and non-contractual adjustments for assigned carriers by CPT code and transfer outstanding balance to secondary insurance or patient responsibility per EOB protocol
  • Conduct audits and coding reviews to ensure all documentation is accurate and precise
  • Assign and sequence all codes for services rendered
  • Assign codes to diagnoses and procedures, using ICD, and CPT codes
  • Search for information on cases where the coding is complex and unusual
  • Close payment batches daily, reconciling individual carrier payments and EOB statements
  • Initiate processes to follow up on rejected claims as evidenced by EOBs, per EOB protocol
  • Transmit all appropriate electronic and paper claims, correct any errors on claims and re-transmit; file secondary claims as necessary
  • Discuss outstanding payment amounts with patients regarding balance owed by the insurance company and the patient
  • Post all payments, by line-item, received for physician’s professional services into EMR software system including co-payments, insurance payments, and patient payments in accordance with practice protocol with an emphasis on accuracy to ensure maximum patient satisfaction and profitability. All payment batches must be balanced in both their dollar value of payments and adjustments prior to posting
  • Review the physician’s coding at charge entry to ensure compliance with Medicare guidelines and to ensure accurate and timely reimbursement
  • Provide customer service on the telephone and in the office for all clients and authorized representatives regarding patient accounts in accordance with practice protocol. Patient calls regarding accounts receivable should be returned within 1 business days to ensure maximum patient satisfaction
  • Verify all demographic and insurance information in patient registration of the EMR software system at the time of charge entry to ensure accuracy, provide feedback to clients and supervisor to ensure timely reimbursement
  • Provide information pertaining to billing, coding, managed care networks, insurance carriers, and reimbursement to physicians, managers and subordinates
  • Follow-up on all returned claims, correspondence, denials, account reconciliations and rebills within five working days of receipt to achieve maximum reimbursement in a timely manner with an emphasis on patient satisfaction
  • Submit primary and secondary insurance claims electronically each day and on HCFA to ensure timely reimbursement
  • Process refunds to insurance companies and patients in accordance with client protocol
  • Monitor reimbursement from managed care networks and insurance carriers to ensure reimbursement consistent with contract rates
  • Proficiency with all facets of the EMR software system including patient registration, charge entry, insurance processing, advanced collections, reports, and ledger inquiry
  • Provide cross coverage for Account Managers in their absence as required to ensure efficient and professional practice operation
  • Maintain information regarding coding, insurance carriers, managed care networks and credentialing in an organized easy to reference format
  • Maintain an organized, efficient, and professional work environment
  • Adhere to all practice policies related to HIPAA and Medicare Compliance

Requirements

  • Preferred 4 years experience in a medical office reimbursement department or medical billing service
  • Highly Preferred Ophthalmology Experience – and experience in Nextech, Nextgen, or other ophthalmology specific EMR/PM software
  • Strong background in Accounts Receivable
  • Strong communication skills as you will be speaking with physician’s, patients, insurance representatives, and/or medical billing staff on a weekly basis
  • Must maintain HIPAA standards
  • Ability to work in a fast-paced environment while remaining calm and professional
  • Strong customer service orientation
  • Excellent organizational skills and must be detailed oriented
  • Strong computer and typing skills
  • Outstanding listening skills
  • Positive, friendly, approachable disposition
  • Ability to work with multiple priorities

Sample job description #2

Join a great orthopedic office that is patient focused and family oriented! We are looking for an energetic, team player who is detail oriented and reliable. This person must have medical billing and coding experience. We would prefer someone with orthopedic experience. Knowledge about DME billing is a plus.

Essential functions and duties:

  • Assign appropriate diagnosis codes using ICD-10
  • Assigns appropriate procedure codes using CPT and HCPCS
  • Links proper diagnosis code with appropriate CPT code for billing purposes
  • Verifies the place of service
  • Query physician for when additional information is needed to complete accurate coding tasks
  • Processing of clinical professional charges in a timely and accurate manner, reviewing, and processing claims edits for accuracy as well as insurance and coding compliance
  • Review submitted claims and work claim rejections
  • Perform collection activities, such as working aged accounts/AR reports to ensure timely and proper maximum reimbursement through various methods including insurance company websites, phone calls, etc.
  • Accurately posts insurance payments received in the mail or through ERA. Posts appropriate denials and tasks to the appropriate team member
  • Maintain working knowledge of changes in medical insurance plans as it pertains to claim billing
  • Provides professional, accurate and timely responses to all accounts receivable inquiries over the phone and in person

Qualifications:

  • Minimum High School or equivalent
  • Certified Biller: CPC or AAPC Certification
  • Medical Billing/Coding: 2 years
  • Orthopedic experience

Sample job description #3

The ABC Company is currently looking for an individual with Medical/Behavioral Health Insurance billing experience, who is able to handle a high volume of claims. Successful candidates are those who posses the ability to work quickly and independently, with the ability to multitask and enjoy a fast paced environment.

Job functions:

  • Perform behavioral health claim billing via electronic submission through a Clearing House
  • Reading and interpreting insurance explanation of benefits (EOBs)
  • Track claim payments and resolve rejected claim issues by re-submitting claims or contacting appropriate insurance companies when applicable
  • Draft effective appeals to insurance companies
  • Utilize reports to follow up on unpaid claims in a timely manner
  • Maintain working knowledge of state and federal billing guidelines
  • Willingness to cross train as needed
  • Other billing related tasks as needed

Job requirements:

  • 2 or more years experience in medical/Behavioral Health billing
  • Experience working with (State) Medicaid/Medicaid MCO’s required
  • Knowledge of Inpatient/Outpatient Behavioral health billing a plus
  • Strong Computer Skills a plus
  • Working knowledge of Insurance Coordination of Benefits
  • Experience with prepayment/post payment audits
  • Working knowledge of Microsoft Excel, Word, and Outlook
  • Knowledge of CPT billing codes for Behavioral Health
  • Problem solving, detail oriented, communication, and organizational skills
  • Ability to work independently

Average salary and compensation

The average salary for a medical biller is $39,800 in the United States. Position salary will vary based on experience, education, company size, industry, and market.

LocationSalary LowSalary High
Phoenix, Arizona$39,600$53,550
Los Angeles, California$44,650$60,400
Denver, Colorado$37,200$50,350
Washington, DC$45,350$61,350
Miami, Florida$37,050$50,100
Orlando, Florida$34,150$46,250
Tampa, Florida$34,500$46,700
Atlanta, Georgia$36,200$48,950
Chicago, Illinois$41,600$56,300
Boston, Massachusetts$45,000$60,850
Minneapolis-St. Paul, Minnesota$35,850$48,500
New York City, New York$47,350$64,100
Philadelphia, Pennsylvania$38,550$52,200
Dallas, Texas$37,550$50,800
Houston, Texas$37,200$50,350
Seattle, Washington$43,300$58,600
National Average$33,850$45,750

Sample interview questions

  • What made you interested in becoming a medical biller?
  • What qualities do you possess that will help you succeed as a medical biller?
  • What medical billing specialties do you have experience with?
  • How do you make sure you are following HIPAA regulations while managing patient records?
  • How do you handle a patient that is upset about the payments they’ve received?
  • What medical terminology are you familiar with?
  • Have you earned any medical billing or coding certifications?
  • What’s the difference between deductibles, copays, and coinsurance?

Medical Biller Jobs in Ashburn

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