Medical Biller/Coder/Accounts Receivable

About Us:

At Elizondo Medical Group, we are dedicated to providing compassionate, patient-centered healthcare of the highest standard. Our dynamic team values clinical excellence, operational efficiency, and integrity. We are seeking an experienced, detail-oriented Medical Biller to join our administrative team and manage our revenue cycle operations. Your expertise will ensure our practitioners remain focused on what they do best: caring for our patients.

Position Summary:

The Medical Biller will oversee the submission of medical claims to insurance providers, manage patient billing inquiries, resolve denials, and closely track outstanding accounts receivable. The ideal candidate possesses deep knowledge of healthcare reimbursement processes, excellent organizational skills, and a strong work ethic.

Key Responsibilities:

Claim Submission & Processing:

Prepare, review, and accurately submit electronic and paper claims to commercial insurance, Medicare, Medicaid, and managed care plans.

Coding & Compliance:

Audit clinical documentation to verify appropriate application of ICD-10-CM, CPT, and HCPCS codes, ensuring compliance with federal and state regulations.

Denial Management & Appeals:

Identify reasons for claim rejections and denials; research, correct, and resubmit appeals with required documentation in a timely manner. Accounts Receivable (A/R)

Follow-Up:

Review aging reports routinely and proactively pursue unpaid or delinquent claims to optimize cash flow and minimize timely filing write-offs.

Patient Account Management:

Post payments, adjustments, and insurance ERAs accurately. Generate patient statements and balance accounts.

Customer Service:

Answer patient phone calls regarding billing discrepancies, payment plans, and insurance verification with empathy and professionalism.

Eligibility Verification:

Perform pre-authorizations and insurance eligibility verifications when required to prevent upstream billing errors.

Supervisory Collaboration:

Regularly meet with the Billing Supervisor to review productivity metrics, discuss complex claim denials, and implement updated billing workflows or policies.

Job Requirements & Qualifications:

Education:

High School Diploma or equivalent required. Associate degree in Health Information Technology or Healthcare Administration is a plus.

Experience:

Minimum of 2-3 years of direct experience as a Medical Biller or Coder in a private practice or outpatient clinic setting. Certifications (Highly Preferred): Certified Professional Coder (CPC), Certified Medical Coder (CMC), or Certified Medical Reimbursement Specialist (CMRS).

Software Proficiency:

Solid experience operating eClinicalWorks Electronic Health Records (EHR) and Practice Management system. Competence with Trizetto clearinghouse.

Regulatory Knowledge:

Up-to-date knowledge of HIPAA regulations, CMS guidelines, Managed Care protocols, and standard commercial insurance practices.

Core Competencies:

Exceptional numerical accuracy, strong analytical problem-solving skills, and a high degree of discretion regarding confidential patient health information.

Job Type:

Full-time Benefits:

Dental insurance Health insurance Life insurance Paid time off Vision insurance

Experience:

ICD-10: 2 years (Required)

CPT Coding:

2 years (Required)

Medical Billing:

2 years (Required)

Work Location:

In person