Medical Biller

Job Description: Medical Biller and Coder (In Person Position)

Location: Fairfield Pediatrics, Wayne, MI

Position Type: Part-Time (in Person)

Starting Pay: $18/hr (with potential for growth based on performance and experience)

About Fairfield Pediatrics

Fairfield Pediatrics is a growing, family-focused pediatric practice dedicated to providing exceptional medical care to children in Wayne, MI, and the surrounding communities. We pride ourselves on fostering a supportive and professional environment for both our patients and staff. We are seeking an experienced and motivated Medical Biller and Coder to join our team in a hybrid capacity, with responsibilities both on-site and remote.

Position Overview

The Medical Biller and Coder will play a critical role in ensuring the financial and operational success of the practice. This individual will handle all aspects of medical billing and coding, insurance management, and patient account oversight, with a specific focus on pediatric services, including immunizations and vaccines for children (VFC).

Key Responsibilities

1. Billing and Coding

- Accurately assign ICD-10, CPT, and HCPCS codes to diagnoses, procedures, and services.

- Bill for immunizations, including the proper use of vaccine-specific codes and administration fees.

- Understand and correctly apply VFC (Vaccines for Children) guidelines to claims.

- Use appropriate modifiers to ensure clean claim submissions and avoid denials.

- Audit patient records for accuracy and compliance with coding and documentation standards.

2. Insurance Management

- Verify patient insurance eligibility and benefits prior to appointments.

- Handle insurance credentialing processes for the practice and maintain updated records.

- Submit and track claims through online platforms such as Availity, CHAMPS, and other insurance portals.

- Communicate with insurance companies to resolve claim issues, denials, and payment discrepancies.

- Appeal denied claims with appropriate documentation and follow up until resolution.

3. Patient Account Management

- Generate and send accurate patient statements.

- Address patient billing inquiries and provide clear explanations of charges and insurance coverage.

- Set up and manage payment plans for patients as needed.

- Maintain detailed records of all billing activities, payments, and adjustments.

4. Compliance and Reporting

- Ensure compliance with HIPAA regulations and medical billing/coding standards.

- Stay updated on changes in coding guidelines, insurance policies, and billing regulations.

- Generate regular reports on billing performance, claim statuses, and account receivables for practice leadership.

Qualifications and Skills

Experience

- Minimum of 2 years of hands-on experience in medical billing and coding, preferably in a pediatric or family practice setting.

- Proven experience with billing for immunizations, VFC vaccines, and using modifiers on claims.

- Familiarity with Availity, CHAMPS, and other online insurance portals is required.

- Experience with insurance credentialing, insurance verification, and understanding patient benefits.

- Familiarity with DRG coding, medical collections, and medical office systems is highly desirable.

- Proficiency in medical terminology and understanding of healthcare documentation processes is essential.

- Strong attention to detail and organizational skills are crucial for success in this role.

- Ability to work independently as well as part of a team in a fast-paced environment.

Education/Certification

- High school diploma or equivalent required; Associate’s degree or higher in a related field preferred.

- Certification in Medical Billing and Coding (CPC, CCS, or equivalent) is strongly preferred.

Technical Skills

- Strong knowledge of ICD-10, CPT, and HCPCS coding systems.

- Proficiency with electronic medical record (EMR) systems and billing software.

- Advanced understanding of insurance claim submission processes, including Medicaid and private insurance.

- Competency with Microsoft Office Suite (Word, Excel) and other relevant software.

Soft Skills

- Exceptional attention to detail and organizational skills.

- Strong written and verbal communication abilities.

- Ability to handle sensitive patient information with discretion and professionalism.

- Problem-solving skills and the ability to work independently or collaboratively.

Work Schedule and Environment

Hybrid Position: Combination of in-person and remote work, with specific in-office days determined by the practice's needs.

Hours: Flexible scheduling, with potential for part-time hours based on mutual agreement.

Benefits and Opportunities

- Starting pay of $18/hr, with opportunities for raises based on performance and tenure.

- Flexible work arrangements to support work-life balance.

- Opportunities for professional development and career advancement.

- Collaborative and supportive team environment in a growing pediatric practice.

How to Apply

If you meet the qualifications and are passionate about contributing to a pediatric healthcare team, we would love to hear from you! Please submit your resume and a cover letter detailing your relevant experience. Be sure to include "Medical Biller and Coder Application" in the subject line.

Fairfield Pediatrics is an equal-opportunity employer and encourages applicants from diverse backgrounds to apply.

Job Type: Part-time

Pay: $17.00 - $21.00 per hour

Expected hours: 8 – 20 per week

Benefits:

• Employee discount
• Flexible schedule

Application Question(s):

• Are you able to provide 3 references from physicians or supervisors you have worked with at your previous jobs?
• Are you willing to come for a 'work interview' to demonstrate your skills?
• Are you a company or an individual?

Experience:

• Billing and coding: 2 years (Required)

Ability to Commute:

• Wayne, MI 48184 (Required)

Work Location: Hybrid remote in Wayne, MI 48184

Salary : $17 - $21