Medical Biller

Department: Revenue Cycle / Billing Employment Type: Full-Time Reports To: Lead Biller / Operations Leadership Company: Power Health Colorado (PHCO) Position Summary Medical Biller – Full-Time Department: Revenue Cycle / Billing Employment Type: Full-Time Reports To: Lead Biller / Operations Leadership Company: Power Health Colorado (PHCO) Power Health Colorado is seeking a full-time Medical Biller to join our Revenue Cycle team. This position is responsible for accurate and timely billing, payment posting, accounts receivable follow-up, denial management, and collection activities across a multidisciplinary medical practice. PHCO treats patients across Workers’ Compensation (WC), Personal Injury (PI), commercial insurance, and other applicable payer types . The ideal candidate is organized, accountable, detail-oriented, and comfortable working in a fast-paced environment where accurate billing and aggressive, appropriate follow-up directly impact the financial performance of the organization. This is not simply a claim-entry position. The Medical Biller is expected to take ownership of assigned accounts from billing through resolution and collection. Key Responsibilities Billing & Claims Review charges and submit accurate claims in a timely manner. Verify CPT, ICD-10, modifiers, provider information, dates of service, and other claim information prior to submission. Identify missing or incomplete documentation that may delay billing or payment. Submit corrected claims, reconsiderations, and appeals when necessary. Maintain accurate billing notes and documentation within the practice management/EHR system. Work closely with providers, clinical staff, front office, and case management to resolve billing issues. Accounts Receivable & Collections Actively work assigned A/R and follow up on outstanding balances. Identify unpaid, underpaid, denied, or incorrectly processed claims. Contact insurance carriers, adjusters, attorneys, funding companies, and other responsible parties as appropriate. Research payment discrepancies and pursue additional reimbursement when appropriate. Escalate aging or high-value accounts requiring additional intervention. Maintain clear documentation of all collection and follow-up activity. Work assigned accounts consistently until payment or appropriate resolution is obtained. Workers’ Compensation Understand and follow Colorado Workers’ Compensation billing requirements and applicable fee schedules. Verify claim information, adjuster/carrier information, authorization status, and billing requirements. Assist with or submit Prior Authorization Requests (PARs) when required. Ensure supporting documentation, invoices, medical records, and other required materials are attached when necessary. Review WC payments for proper reimbursement and identify potential underpayments. Follow up directly with carriers and adjusters regarding unpaid or disputed balances. Personal Injury Maintain accurate billing records for PI cases, including direct lien and other applicable arrangements. Coordinate with case management and attorneys regarding case status when necessary. Ensure bills and supporting documentation are available and submitted appropriately. Track outstanding PI balances and assist with settlement, reduction, or payment-related requests according to PHCO procedures. Maintain accurate financial information so leadership and case management have reliable visibility into outstanding balances. Payment Posting & Reconciliation Accurately post insurance, patient, attorney, funding, and other payments. Apply contractual adjustments and other approved adjustments appropriately. Identify discrepancies between billed charges, expected reimbursement, and actual payment. Ensure payments are applied to the correct patient, claim, provider, and date of service. Assist with reconciliation and reporting as requested. Denials & Appeals Review denials promptly and determine the root cause. Correct billing errors and resubmit claims when appropriate. Prepare appeals and provide supporting documentation. Track recurring denial trends and communicate systemic issues to leadership. Help identify opportunities to prevent future denials rather than repeatedly correcting the same issue. Performance Expectations & KPIs Performance will be evaluated using measurable Revenue Cycle outcomes, including: Clean Claim Rate: 95%+ Timely Claim Submission: 95%+ of claims submitted within established PHCO standards Payment Posting Accuracy: 98%+ Denial Follow-Up: Initial action within 5 business days A/R Follow-Up: Assigned accounts worked according to established aging and priority standards A/R Aging: Consistent reduction of balances greater than 60 and 90 days Underpayment Identification: Timely identification and follow-up of reimbursement discrepancies Documentation: 100% of collection and follow-up activity appropriately documented Productivity: Completion of assigned billing and A/R workload within established departmental expectations The expectation is not simply to “touch” accounts. Accounts should move toward resolution and collection. Qualifications Required Previous medical billing, revenue cycle, or healthcare A/R experience. Working knowledge of CPT, ICD-10, modifiers, EOBs/ERAs, denials, and claim follow-up. Strong attention to detail and organizational skills. Ability to manage a high-volume workload and prioritize accounts appropriately. Strong written and verbal communication skills. Comfortable communicating with insurance carriers, adjusters, attorneys, patients, and internal staff. Ability to maintain patient confidentiality and comply with HIPAA requirements. Preferred Experience with Workers’ Compensation and/or Personal Injury billing . Knowledge of Colorado Workers’ Compensation billing and fee schedules. Experience with PARs, appeals, and authorization requirements. Experience with eClinicalWorks (eCW) or similar EHR/practice management systems. Experience working within a multidisciplinary medical practice. Bilingual English/Spanish is a plus. What We Are Looking For We are looking for someone who takes ownership of their work. The right person does not wait for an aging report to become a problem before taking action. Successful PHCO billers are: Accountable and dependable Highly organized Detail-oriented Persistent with follow-up Comfortable asking questions and identifying problems Able to work independently while remaining part of a team Focused on both accuracy and collections Interested in improving processes instead of simply maintaining them About Power Health Colorado Power Health Colorado is a multidisciplinary healthcare organization providing coordinated medical and rehabilitation services across multiple Colorado locations. Our teams work collaboratively across medical, rehabilitation, case management, and revenue cycle functions to provide high-quality care while maintaining strong operational and financial standards. Power Health Colorado is an Equal Opportunity Employer. #J-18808-Ljbffr