Out of Network Medical Biller

Job Description

Job Description

Out-of-Network Medical Biller

We are seeking an experienced Out-of-Network Medical Biller to join our growing medical practice. The ideal candidate must have strong experience handling out-of-network claims, insurance follow-up, appeals, and reimbursement processes.

Responsibilities:

• Submit and manage out-of-network insurance claims accurately and timely
• Follow up on unpaid or denied claims with insurance carriers
• Handle appeals, reconsiderations, and payment disputes
• Verify patient benefits and out-of-network coverage
• Post payments, reconcile accounts, and monitor accounts receivable
• Communicate with patients regarding balances, billing questions, and payment arrangements
• Work closely with providers and administrative staff to maximize reimbursements
• Maintain accurate documentation and ensure HIPAA compliance

Qualifications:

• Minimum 2–3 years of out-of-network medical billing experience required
• Strong understanding of insurance claims, EOBs, denials, appeals, and reimbursement methodologies
• Experience with commercial insurance plans and out-of-network negotiations preferred
• Knowledge of CPT, ICD-10, and medical terminology
• Familiarity with EMR/EHR and billing software
• Strong attention to detail, organizational skills, and ability to multitask
• Excellent communication and problem-solving skills

We offer a competitive salary, a professional work environment, and opportunities for growth. Candidates with proven out-of-network billing experience are encouraged to apply.