In House Medical Biller

THIS IS AN IN- OFFICE POSITION. WE ARE NOT HIRING FOR A REMOTE POSITION AT THIS TIME

Job Summary

Well Rooted Pediatrics is seeking an In-House Medical Biller to join our team! As a Medical Biller, you will be working closely with parents to answer questions related to billing, processing all forms needed for insurance billing purposes, and collecting necessary documentation. The ideal candidate has excellent attention to detail, strong customer service skills, and is comfortable spending much of the day on the phone.

What We’re Looking For

Someone who takes ownership of the billing process, not just completes tasks

A proactive problem-solver who identifies issues and helps fix them

A team player who communicates effectively with clinical and front desk staff

Someone who wants to grow with a collaborative, forward-thinking practice

Responsibilities

Patient Information Management: Accurately enter and maintain patient demographic and insurance information in the billing system.

Claims Submission: Prepare and submit insurance claims to various payers, including government and private insurance companies, ensuring compliance with billing regulations.

Claim Follow-Up: Monitor claim status, identify and resolve billing discrepancies, and follow up on outstanding claims to facilitate timely payments.

Insurance Verification: Verify patient insurance coverage and eligibility, including pre-authorization requirements.

Billing Inquiries: Respond to patient and insurance inquiries regarding billing issues, providing excellent customer service.

Payment Posting: Record and reconcile payments received from patients and insurance companies. Ensure all payments received from the insurance carriers match the contractual allowances for services rendered.

Documentation and Reporting: Maintain accurate records of billing and claims activities, generating reports as needed.

Obtain and review insurance reimbursement schedules quarterly.

Patient Payments: Work patient balance reports and process patient statements weekly. Charge cards on file if necessary to obtain payment. Review patient credits to initiate refund. Handle collections on unpaid accounts; both insurance and self-pay

Maintain patient confidentiality and adhere to HIPAA regulations

Assist front desk staff with any insurance questions

At times may as well be asked to assist with front desk responsibilities; answering phones, scheduling appointments, checking in and out patients

Qualifications

Minimum of 2 years of experience with pediatric billing, including:

Strong knowledge of CPT, ICD-10, and payer guidelines

Vaccines (including VFC workflows)

Well visit + sick visit coding and modifier usage

Proven ability to manage A/R and resolve denials independently

Experience with EMR/EHR and billing systems, Elation EHR preferred

Strong attention to detail and problem-solving skills

Excellent communication and organizational skills

Strong customer service skills

Capability to bill for all insurances and must have a strong knowledge of BCBSM, Medicaid, Medicaid HMOs and Private HMOs

Strong understanding of insurance benefits

Preferred (but not required)

Certified Professional Biller (CPB) or CPC

Experience in a busy outpatient pediatric practice

Familiarity with Elation EHR and Elation Billing

Why Join Us

Supportive, team-oriented environment

Opportunity to build and improve internal billing systems

Direct collaboration with providers and management team

Meaningful role impacting both patient experience and practice growth

Flexible work from home options available.