Physician Biller

Description Job SummarySeeking highly detail-oriented and performance-driven Physician Medical Billers to join our team. This role is responsible for accurate and timely billing, claims management, and accounts receivable follow-up across multiple client systems. Success in this position requires strong productivity, quality, and compliance performance in alignment with defined KPIs and service level agreements (SLAs).Key Responsibilities Prepare, review, and submit medical claims (electronic and paper), including CMS-1500 (HCFA) claim forms for physician services Ensure accurate completion of all required CMS-1500 fields, including provider information, NPI, place of service, diagnosis codes (ICD-10), procedure codes (CPT/HCPCS), modifiers, and charge amounts Verify patient insurance eligibility and benefits prior to claim submission Identify and correct claim errors before submission to minimize denials and rework Manage accounts receivable, including denial follow-up, corrections, and timely resubmission of claims Reconcile accounts with payer remittances (EOBs/ERAs) Ensure compliance with payer-specific billing guidelines and federal regulations Communicate with providers, payers, and patients regarding billing discrepancies Work across multiple billing systems (up to 4 client platforms)Salary & Benefits: Up to $22.00 per hour (dependent on experience) Medical/Dental/Vision health insurance offered Paid Vacation/Sick/Holiday Time 401K Position Requirements CMS-1500 (HCFA) Expertise Requirements Demonstrated experience completing and auditing CMS-1500 forms for physician billing Strong understanding of claim form fields including: Box 21 (Diagnosis Codes) and proper sequencing Box 24 (Service line details including CPT/HCPCS, modifiers, charges, units, and rendering provider) Box 17/17b (Referring provider information when applicable) Box 31-33 (Billing provider, group information, and NPI accuracy) Ability to troubleshoot rejected or denied claims related to form errors, missing data, or payer-specific requirements Knowledge of electronic claim equivalents (837P transactions) and clearinghouse edits Ensure claims meet "clean claim" standards prior to submission to maximize first-pass acceptanceTechnical KnowledgeStrong knowledge of: CPT (Current Procedural Terminology) codes ICD-10 diagnosis coding HCPCS Level II codes Proficiency in completing and reviewing CMS-1500 (HCFA) claim forms Experience with electronic claims (837P) and clearinghouses Familiarity with payer guidelines: Medicare Medicaid Commercial insurance plans Performance Expectations (KPI & SLA Standards)Performance Expectations (KPI and SLA Standards)Productivity: Standard: 60-64 accounts per day (6-8 accounts/hour) Minimum: 56 accounts/day High Performance: 65+ accounts/day (while meeting quality standards) Productivity adjusted based on number of active client systems (48-64 accounts/day range)Training Ramp (First 120 Days): Gradual productivity increase from training phase to full production Full productivity expected by Day 91-120Quality Standards: Claim accuracy: ≥98% First-pass resolution: ≥90% Biller-caused denial rate: ≤3% Error rate progression: ≤5% (first 30 days) ≤3-4% (31-60 days) ≤2% (60+ days)Service Level Agreements (SLAs): Charge entry: Same-day Claims/rejections: Within 24 hours Denial follow-up: Within 48 hours AR (30-90 days): Weekly follow-up requiredQuality Assurance: Increased QA review during training, transitioning to 10-15% ongoing audits once fully trained Work Standards & Compliance Maintain 95%+ schedule adherence Ensure 100% documentation completeness Maintain a secure, HIPAA-compliant remote work environment Participate in QA reviews, coaching, and performance improvement plans (if needed)Qualifications Minimum 2+ years of physician medical billing experience Strong knowledge of CPT, ICD-10, and HCPCS coding Experience with EMR/EHR systems and billing platforms Familiarity with Medicare, Medicaid, and commercial payers Strong analytical, organizational, and problem-solving skills Ability to manage multiple systems and meet deadlines in a high-performance environmentPerformance & Accountability Productivity credit is tied to quality (clean claims vs. rework) Coaching provided for productivity gaps; corrective action for quality/SLA issues Performance Improvement Plans (PIPs) may be implemented if standards are not met Full-Time/Part-Time Full-Time Shift -not applicable- Company Website Rate of Pay Up to $22.00 per hour dependent on experience EOE Statement We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law. This position is currently accepting applications.

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