Medical biller and revenue cycle management specialist

About Us

We are a leading internal medicine practice specializing in high-quality patient care with a focus on echocardiograms, sleep studies, and other diagnostic services. We are committed to providing excellent patient experiences while ensuring smooth and efficient revenue operations. To maintain our high standards, we are looking for an experienced Medical Biller and Revenue Cycle Management Specialist to join our team.


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Position Overview

The ideal candidate will have a minimum of 5 years of experience in medical billing and revenue cycle management, with proven expertise in using Kareo or Tebra software. You will play a critical role in managing the complete billing cycle, including claims submission, denial and rejection management, and ensuring timely resolution of no-response claims. This role requires experience working with United Healthcare and Optum clients and a track record of delivering excellent results in revenue recovery.Must have worked with a United States based clinic.


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Key Responsibilities

Claims Management:

Submit clean claims daily for services provided, including echos and sleep studies.

Monitor and follow up on denials, rejections, and no-response claims promptly to ensure timely payment.

Correct and resubmit claims with errors or additional requirements.

Ensure all billing codes (CPT, ICD-10, and modifiers) are accurate and compliant with payer requirements.


Revenue Optimization:

Analyze trends in claim denials and develop strategies to minimize them.

Regularly audit billing processes to identify and address inefficiencies.

Maximize reimbursement through the effective use of coding and documentation best practices.


Payer Communication:

Collaborate with insurance companies, including United Healthcare and Optum to resolve complex claim issues.

Stay updated on payer-specific guidelines and policy changes that impact claims.


Patient Billing Support:

Address patient billing inquiries professionally and resolve issues promptly.

Prepare and send patient statements accurately and on time.


Reporting:

Generate detailed reports on accounts receivable, claim status, and revenue cycle metrics.

Provide recommendations based on trends and key performance indicators (KPIs).




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Qualifications

Required Skills and Experience:

Minimum of 5 years of experience in medical billing and revenue cycle management.

Proficiency in Kareo or Tebra software is mandatory.

Strong knowledge of medical coding (CPT, ICD-10, HCPCS) and compliance standards.

Proven track record of managing denials, rejections, and no-response claims efficiently.

Experience working with United Healthcare and Optimus clients.

Familiarity with billing and coding for echocardiograms and sleep studies.

Strong analytical and problem-solving skills with a focus on revenue recovery.

Excellent verbal and written communication skills.

High attention to detail and the ability to work independently.


Preferred Qualifications:

Certification in medical billing and coding (e.g., CPC, CMRS).

Experience in an internal medicine practice or similar specialty.

Familiarity with HIPAA regulations and compliance.