Physician Biller - 259871

Physician Biller

Location: Belle Vernon, PA (On-site)

Position Type: Full-Time (40 hours/week)

Schedule: Monday – Friday, 8:00 AM – 5:00 PM

Position Overview

We are seeking a detail-oriented and experienced Physician Biller to join our team on-site in Belle Vernon, PA. In this role, you will play an integral part in the physician revenue cycle—managing professional claim submissions, resolving denials, reviewing patient accounts, and conducting timely insurance follow-up to ensure accurate and prompt reimbursement.

Key Responsibilities

• Claims Preparation & Submission: Prepare, review, and submit clean professional claims to commercial insurance payers, Medicare, Medicaid, and managed care plans.
• Coding & Claim Verification: Review claims prior to submission to ensure accuracy of CPT, HCPCS, ICD-10-CM diagnosis codes, modifiers, units, billing provider information, and place-of-service requirements.
• Practice Management & Charge Entry: Enter and maintain patient demographic information, charges, payments, adjustments, authorizations, and referrals within the practice management system.
• EHR System Utilization: Leverage eClinicalWorks (eCW) to enter charges, track claims, review account history, document billing activity, and monitor outstanding balances.
• Denials & Accounts Receivable: Investigate and resolve claim rejections, denials, and underpayments; correct billing errors and resubmit claims promptly.
• Aging & Follow-Up: Work insurance accounts receivable (A/R) aging reports, prioritizing accounts based on payer deadlines, balances, and aging brackets.
• Payer Communication: Contact insurance payers directly to resolve unpaid or pending claims, clarify payment discrepancies, verify eligibility, and address authorization issues.
• EOB/ERA Review: Accurately interpret Explanations of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to determine appropriate contractual adjustments, write-offs, and next steps.

Required Qualifications

• Experience: Minimum of 2 years of physician / professional medical billing experience.
• Revenue Cycle Knowledge: In-depth understanding of the end-to-end physician revenue cycle (charge entry, claim submission, payment posting, A/R, and denial management).
• Payer Familiarity: Demonstrated experience billing and following up with Medicare, Medicaid, commercial carriers, and third-party payers.
• Coding & Terminology: Working knowledge of CPT, HCPCS, ICD-10-CM coding systems and medical billing terminology.
• Denials Resolution: Proven track record of researching, correcting, and appealing claim denials and underpayments.
• Technical Skills: Proficiency with electronic health record (EHR) and practice management software.

Preferred Qualifications

• Hands-on experience with eClinicalWorks (eCW) .
• Solid grasp of billing modifier usage and place-of-service coding rules.
• Familiarity with managed-care contract guidelines and payer-specific billing rules.