Physician Biller II

Physician Biller II

Seeking highly detail-oriented and performance-driven Physician Medical Billers to join our team. This role is responsible for accurate and timely billing, claims management, and accounts receivable follow-up across multiple client systems. Success in this position requires strong productivity, quality, and compliance performance in alignment with defined KPIs and service level agreements (SLAs).

Key Responsibilities:

• Prepare, review, and submit medical claims (electronic and paper), including CMS-1500 (HCFA) claim forms for physician services
• Ensure accurate completion of all required CMS-1500 fields, including provider information, NPI, place of service, diagnosis codes (ICD-10), procedure codes (CPT/HCPCS), modifiers, and charge amounts
• Verify patient insurance eligibility and benefits prior to claim submission
• Identify and correct claim errors before submission to minimize denials and rework
• Manage accounts receivable, including denial follow-up, corrections, and timely resubmission of claims
• Reconcile accounts with payer remittances (EOBs/ERAs)
• Ensure compliance with payer-specific billing guidelines and federal regulations
• Communicate with providers, payers, and patients regarding billing discrepancies
• Work across multiple billing systems (up to 4 client platforms)

Salary & Benefits:

• Up to $24.00 per hour (dependent on experience)
• Medical/Dental/Vision health insurance offered
• Paid Vacation/Sick/Holiday Time
• 401K

Position Requirements:

• Demonstrated experience completing and auditing CMS-1500 forms for physician billing
• Strong understanding of claim form fields including: Box 21 (Diagnosis Codes) and proper sequencing Box 24 (Service line details including CPT/HCPCS, modifiers, charges, units, and rendering provider) Box 17/17b (Referring provider information when applicable) Box 3133 (Billing provider, group information, and NPI accuracy)
• Ability to troubleshoot rejected or denied claims related to form errors, missing data, or payer-specific requirements
• Knowledge of electronic claim equivalents (837P transactions) and clearinghouse edits
• Ensure claims meet "clean claim" standards prior to submission to maximize first-pass acceptance
• Strong knowledge of: CPT (Current Procedural Terminology) codes ICD-10 diagnosis coding HCPCS Level II codes Proficiency in completing and reviewing CMS-1500 (HCFA) claim forms Experience with electronic claims (837P) and clearinghouses Familiarity with payer guidelines: Medicare Medicaid Commercial insurance plans

Performance Expectations (KPI & SLA Standards):

• Qualifications: Minimum 2+ years of physician medical billing experience Strong knowledge of CPT, ICD-10, and HCPCS coding Experience with EMR/EHR systems and billing platforms Familiarity with Medicare, Medicaid, and commercial payers Strong analytical, organizational, and problem-solving skills Ability to manage multiple systems and meet deadlines in a high-performance environment
• Productivity credit is tied to quality (clean claims vs. rework) Coaching provided for productivity gaps; corrective action for quality/SLA issues Performance Improvement Plans (PIPs) may be implemented if standards are not met

This position is currently accepting applications.