Rheumatology Medical Biller - PT / FT (local position)

Job Description

Job Description

Rheumatology Medical Biller

We are an independent physician-owned rheumatology practice, is seeking an experienced Medical Biller to join our team.

We are looking for someone who is detail-oriented, organized, accountable, and comfortable working across the full revenue cycle. Rheumatology, infusion, specialty medication, and eClinicalWorks (eCW) experience are strongly preferred.

This is a hands-on role requiring someone who can identify problems, research discrepancies, follow issues through resolution, and help ensure that services provided are accurately billed and reimbursed.

Key Responsibilities

• Review and submit professional claims for office visits, procedures, injections, infusions, and medications.
• Review charges for accuracy, including CPT/HCPCS codes, units, modifiers, diagnosis codes, and payer-specific billing requirements.
• Ensure infusion/injection medications and administration services are accurately captured and billed.
• Review documentation and identify potential coding or charge discrepancies before claim submission.
• Post insurance payments, ERAs/EOBs, adjustments, denials, and patient responsibility accurately in eCW.
• Reconcile posted payments to EOBs/ERAs and identify posting discrepancies.
• Work clearinghouse rejections and claim edits promptly.
• Review unpaid and underpaid claims and perform appropriate follow-up with payers.
• Work denials, corrected claims, reconsiderations, and appeals through resolution.
• Monitor accounts receivable and prioritize aging and high-dollar accounts.
• Research payer policies, LCD/NCD requirements, authorization issues, coding requirements, and reimbursement discrepancies as needed.
• Review infusion and specialty medication claims for correct drug codes, units, administration codes, diagnosis support, and reimbursement.
• Assist with buy-and-bill medication reconciliation and identification of missed or incorrect charges.
• Identify trends in denials, coding errors, payment discrepancies, or workflow failures and escalate concerns appropriately.
• Maintain clear documentation of billing follow-up and actions taken.
• Assist with patient account questions and insurance-related billing issues as needed.
• Follow established compliance, documentation, and revenue-cycle policies and procedures.
• Collaborate with providers, nurses, front-office staff, authorization staff, and management to resolve billing issues.

Qualifications

• Prior medical billing/revenue-cycle experience required.
• Rheumatology, infusion, injection, or specialty medication billing experience strongly preferred.
• Experience with physician-administered buy-and-bill medications highly preferred.
• Working knowledge of CPT, HCPCS, ICD-10-CM, modifiers, Medicare and commercial payer billing requirements.
• Experience with charge entry/review, payment posting, ERA/EOB processing, denials, appeals, and accounts receivable.
• eClinicalWorks (eCW) experience strongly preferred.
• Experience with Medicare LCD/NCD requirements and medical-necessity review preferred.
• CPC, CPB, or other coding/billing certification is a plus but not required with strong applicable experience.

What We Are Looking For

The ideal candidate:

• Has exceptional attention to detail and catches discrepancies before they become larger problems.
• Understands that a paid claim is not necessarily an accurately billed claim.
• Is comfortable researching unfamiliar billing or payer issues rather than simply passing them along.
• Takes ownership of issues and follows them through resolution.
• Can manage multiple priorities and high-dollar claims without losing track of follow-up.
• Communicates clearly with clinical and administrative staff.
• Recognizes patterns and proactively identifies opportunities to improve workflows.
• Is dependable, organized, and able to work independently while functioning as part of a team.
• Is comfortable learning the complexities of rheumatology medications and payer requirements.

Preferred Experience

Experience with rheumatology and medications such as biologic infusions/injections, osteoporosis therapies, or other physician-administered specialty medications is highly desirable. Familiarity with Medicare, Medicare Advantage, commercial insurance, specialty pharmacy/white-bagging issues, prior authorizations, and specialty-drug reimbursement is also beneficial.

Arthritis & Osteoporosis Treatment Center (AOTC) is an independent, physician-owned rheumatology practice in Orange Park, Florida, specializing in the care of patients with arthritis, osteoporosis, and autoimmune conditions.

Our team provides comprehensive outpatient care, including in-office infusion and injection services. Many of our infusion patients return regularly for treatment, allowing our nurses to develop meaningful, long-term patient relationships.

We value compassionate patient care, teamwork, clear communication, accountability, and initiative. As a small practice, every team member plays an important role in patient care and daily operations. We welcome individuals who take ownership of their responsibilities, anticipate needs, adapt to changing priorities, and contribute to a positive, professional work environment.

We look forward to welcoming an experienced infusion RN who takes pride in delivering safe, attentive, and personalized patient care.

We value compassionate patient care, teamwork, clear communication, and accountability. As a small practice, each team member plays an important role in supporting our patients and keeping daily operations running smoothly. We welcome individuals who take initiative, adapt to changing needs, and contribute to a positive, professional work environment.

Company Description

Arthritis & Osteoporosis Treatment Center (AOTC) is an independent, physician-owned rheumatology practice in Orange Park, Florida, specializing in the care of patients with arthritis, osteoporosis, and autoimmune conditions.\n\nOur team provides comprehensive outpatient care, including in-office infusion and injection services. Many of our infusion patients return regularly for treatment, allowing our nurses to develop meaningful, long-term patient relationships.\n\nWe value compassionate patient care, teamwork, clear communication, accountability, and initiative. As a small practice, every team member plays an important role in patient care and daily operations. We welcome individuals who take ownership of their responsibilities, anticipate needs, adapt to changing priorities, and contribute to a positive, professional work environment.\n\nWe look forward to welcoming an experienced infusion RN who takes pride in delivering safe, attentive, and personalized patient care.\n\nWe value compassionate patient care, teamwork, clear communication, and accountability. As a small practice, each team member plays an important role in supporting our patients and keeping daily operations running smoothly. We welcome individuals who take initiative, adapt to changing needs, and contribute to a positive, professional work environment.\n