Medical Biller- Full Time

TNT Healthcare Billing Solutions is seeking a dedicated and detail-oriented Medical Biller to manage full-cycle revenue operations for medical clinics throughout the Twin Cities. The ideal candidate will possess in-depth knowledge of medical billing, coding, insurance claims processing, and revenue cycle management. This role involves end-to-end management of the billing process, from patient registration to final payment, ensuring accuracy, compliance, and efficiency.

Responsibilities:

Medical Billing and Coding:

• Review medical documentation and accurately assign appropriate codes using ICD-10, CPT, and HCPCS code sets.

• Ensure coding compliance with industry standards, payer guidelines, and regulatory requirements.

• Verify and update patient demographic and insurance information as necessary.

Claim Generation and Submission:

• Generate accurate and complete claims based on coded information.

• Submit claims electronically or by paper according to payer requirements.

• Validate claim information, including patient and provider details, services rendered, and billed amounts.

Claim Follow-Up and Resolution:

• Monitor and track claim submissions to insurance companies.

• Follow up on unpaid or denied claims, investigating reasons for denials or rejections.

• Take necessary actions to resolve claim issues, including submitting appeals, correcting errors, or resubmitting claims.

Payment Posting and Reconciliation:

• Accurately post payments and adjustments received from insurance companies, patients, and other payers.

• Identify and resolve payment discrepancies, including overpayments, underpayments, and non-payments.

• Reconcile accounts receivable balances and ensure accuracy of financial records.

Insurance and Patient Communication:

• Communicate with insurance companies to verify coverage, resolve claim issues, and obtain necessary information.

• Interact with patients to address billing inquiries, explain charges, and assist with payment arrangements.

• Provide clear and concise explanations of insurance benefits, patient responsibilities, and payment options.

Documentation and Reporting:

• Maintain accurate and organized records of billing activities, claim status, and payment history.

• Generate reports on billing and reimbursement metrics, identifying trends, issues, and opportunities for improvement.

• Adhere to confidentiality and privacy regulations in handling sensitive patient and billing information.

Compliance and Quality Assurance:

• Stay updated on industry changes, regulatory guidelines, and insurance policies related to medical billing.

• Ensure compliance with coding and billing regulations, including HIPAA and relevant billing standards.

• Participate in internal quality assurance activities to maintain accuracy and adherence to best practices.

Qualifications:

• High school diploma or equivalent; additional certification in medical billing or coding is preferred.

• Proven experience as a Medical Biller or in a similar role.

• Strong knowledge of medical billing procedures, coding systems (ICD-10, CPT, HCPCS), and insurance regulations.

• Proficiency in medical billing software and electronic health record (EHR) systems.

• Excellent attention to detail, with the ability to accurately review and analyze medical documentation.

• Strong communication skills, both written and verbal, with the ability to interact professionally with insurance companies, providers, and patients.

• Ability to work independently and meet deadlines in a fast-paced environment.

• Problem-solving skills, with the ability to identify and resolve claim-related issues.

• Familiarity with medical terminology and healthcare billing practices.

Location: Remote (Must reside in Minnesota or Wisconsin to attend in-person meetings twice a month)

Job Type: Full-Time