Certified Medical Biller and Coder

Benefits 401(k) 401(k) matching Competitive salary Dental insurance Health insurance Opportunity for advancement Paid time off Training & development Vision insurance Role Overview We are seeking a highly detail-oriented Medical Biller with specialized experience in Pain Management, Orthopedics, Imaging, Physical Therapy, and Home Health billing. The ideal candidate isn't just a data entry clerk; you are a denial management expert who understands the complexities of Workers’ Compensation (IWCC) and commercial insurance claims. You will take ownership of the revenue cycle, from initial submission to the final appeal of a denial. Specific Requirements Specialty Expertise: Proven experience billing for Professional Imaging, Physical Therapy (understanding timed units), and Home Health services. Injury Claim Specialist: Deep understanding of Commercial and Injury claims, specifically navigating the Illinois Workers’ Compensation Commission (IWCC) guidelines. Portal Proficiency: Daily experience using Availity, Connex, and IWCC portals for claim status and eligibility. The “Appeal Artist”: You don’t just accept a denial; you know how to interpret an EOB, identify the root cause, and craft winning appeals to recover revenue. Technical Skills: Proficient in Microsoft Office (specifically Excel for AR tracking) and experienced with EHR/Billing software. Key Responsibilities Full-Cycle Claims: Generate and submit electronic and paper claims with 100% accuracy. Coding Integrity: Review patient records to ensure CPT, ICD-10-CM, and HCPCS codes align with services rendered. Denial & Appeal Management: Actively resolve rejected claims and manage the formal appeal process for disputed payments. AR & Payment Posting: Accurately post payments, manage accounts receivable, and perform diligent follow-ups on outstanding balances. Verification & Authorization: Verify insurance eligibility and secure pre-authorizations to prevent front-end denials. Patient Advocacy: Act as a resource for patients, clearly explaining benefits and answering billing inquiries with professionalism. Monitor Denials and Corrections: Track claim denials, identify errors, and resubmit correct claims. Patient Billing and Collections: Generate invoices for patients, manage outstanding balances and handle payment plans. Education & Experience Medical Billing/Coding Certificate or Associate degree is required. If no billing and coding certificate is available, a recent graduate of the medical billing and coding program will be required. Minimum 2+ years of experience in medical billing and collections or a recent graduate of a Certified Medical Billing and Coding program is required. Firm grasp of HIPAA, CMS guidelines, and insurance compliance. Spanish Speaking preferred but not required. Be willing to work Full time with no restrictions. Pay $17.00 – 19.50 Hours / Schedule Monday through Friday 8:00 am to 4:00 pm. Occasional Saturday with a rotating schedule with the rest of the billing team. Location Fullerton/Kimball Surgical Center 3412 W. Fullerton Ave. Chicago, IL 60647 Additional Benefits and Perks (if full time hours are met) AFLAC insurance: Available after 90 days of employment. Health, Vision, and Dental after 90 days of employment, Employer will pay 50%. 5 paid sick days per year, 2 weeks paid vacation after 1 year of employment. 401K Matching: 1% non-contributing match provided by the company, up to 4% match with employee contributions after 1 year of employment. #J-18808-Ljbffr