Core Responsibilities

• Create Claims: Turn medical information into insurance claims using correct billing codes.
• Submit to Insurance: Send claims to insurance companies electronically or by mail.
• Bill Patients: Send invoices to patients for copays, deductibles, or leftover balances.
• Fix Denied Claims: Investigate and appeal claims that insurance companies reject.
• Track Payments: Post incoming payments and update patient account records. 

Daily Tasks

• Check patient insurance coverage before appointments.
• Talk with insurance agents to check on claim progress.
• Set up payment plans for patients.
• Keep all patient data private under HIPAA rules. 
• Reporting for office/update monthly for outstanding bills/payments

This is an in office position Mon-Friday 8a-430p, Saturday PRN 8a-12p. This is not a remote position. 

 Education & Experience

• High school diploma or equivalent is the minimum requirement for entry-level roles.
• 1 to 2 years of experience in a medical office, clerical role, or customer service setting is highly valued.
• Billing/Coder certification or degree

Professional Certifications While not always legally required, having a certification significantly increases your job prospects and earning potential. The most recognized credentials include:

• Certified Professional Biller (CPB) – Offered by the AAPC.
• Certified Medical Reimbursement Specialist (CMRS) – Offered by the AMBA.
• Certified Medical Billing Specialist (CMBS) – Offered by the MAB.

Key Skills & Qualifications

• Medical Coding Knowledge: Basic understanding of ICD-10, CPT, and HCPCS codes to read medical records and submit accurate claims.
• Software Proficiency: Familiarity with Electronic Health Records (EHR) and medical billing software (such as Epic, eClinicalWorks, or Azalea).
• Financial Literacy: Strong math skills for processing payments, calculating copays, and balancing accounts.
• HIPAA Compliance: Deep understanding of medical privacy laws to keep patient data secure.
• Communication: Clear communication skills to explain complex bills to patients and negotiate with insurance adjusters.