MEDICAL BILLER - FULL TIME - PEDIATRICS chez Keystone Pediatrics

About the Role:

The Medical Biller at Keystone Pediatrics plays a critical role in ensuring the financial health and operational efficiency of our pediatric healthcare services. This position is responsible for accurately processing and submitting medical claims to insurance companies and patients, ensuring timely reimbursement for services rendered. The role requires meticulous attention to detail to verify patient information, coding accuracy, and compliance with healthcare regulations. The Medical Biller will collaborate closely with healthcare providers, insurance companies, and patients to resolve billing discrepancies and answer inquiries. Ultimately, this position supports the practice’s mission by facilitating smooth revenue cycles and enabling continued delivery of high-quality pediatric care.

Minimum Qualifications:

• High school diploma or equivalent required; Associate degree or certification in medical billing or health information management preferred.
• Proven experience in medical billing, preferably within a pediatric healthcare setting.
• Strong knowledge of medical billing software and electronic health record (EHR) systems.
• Familiarity with ICD-10, CPT, and HCPCS coding standards.
• Excellent attention to detail and organizational skills.

Preferred Qualifications:

• Certification as a Certified Professional Biller (CPB) or Certified Coding Specialist (CCS).
• Experience working with pediatric insurance plans and Medicaid billing.
• Proficiency in using billing and practice management software specific to pediatrics.
• Strong customer service skills with experience handling sensitive patient information.
• Ability to analyze billing data to identify trends and improve revenue cycle processes.

Responsibilities:

• Prepare and submit accurate medical claims to insurance companies and patients in a timely manner.
• Review patient records and verify insurance coverage and eligibility before billing.
• Ensure proper coding of diagnoses and procedures in compliance with current healthcare regulations and standards.
• Follow up on unpaid or denied claims, working with insurance companies and patients to resolve issues.
• Maintain detailed and organized billing records and documentation for auditing and reporting purposes.
• Communicate effectively with healthcare providers, insurance representatives, and patients regarding billing questions and concerns.
• Stay updated on changes in billing regulations, insurance policies, and pediatric healthcare coding standards.

Skills:

The Medical Biller utilizes their expertise in medical coding and billing software daily to ensure claims are accurately prepared and submitted, minimizing errors and delays. Strong communication skills are essential for interacting with insurance companies, healthcare providers, and patients to clarify billing issues and resolve disputes efficiently. Attention to detail is critical when reviewing patient records and insurance information to maintain compliance with healthcare regulations and coding standards. Organizational skills help manage multiple billing accounts and follow up on outstanding claims systematically. Additionally, staying current with industry changes allows the Medical Biller to adapt processes and maintain the integrity of the revenue cycle within the pediatric healthcare environment.

Equal Opportunity Employer