Medical Biller

Position Summary

The Medical Biller is responsible for preparing, submitting, and managing medical claims to insurance companies and patients. This role ensures accurate billing, timely reimbursement, and compliance with all healthcare regulations and payer requirements.

Key Responsibilities

• Prepare and submit accurate medical claims to insurance companies (electronic and paper)
• Verify patient insurance eligibility and benefits prior to billing
• Review patient accounts for accuracy, including coding, charges, and documentation
• Follow up on unpaid or denied claims and resolve billing issues promptly
• Post payments from insurance companies and patients
• Process adjustments, refunds, and payment plans as needed
• Communicate with insurance companies regarding claim status, denials, and appeals
• Work with providers and clinical staff to resolve coding or documentation discrepancies
• Maintain up-to-date knowledge of billing regulations, coding updates, and payer guidelines
• Ensure compliance with HIPAA and all applicable healthcare regulations
• Generate billing reports and assist with audits as required

Qualifications

• High school diploma or equivalent required; associate degree or certification in medical billing/coding preferred
• 1–3 years of experience in medical billing, preferably in a healthcare or behavioral health setting
• Knowledge of CPT, ICD-10, and HCPCS coding systems
• Experience with Medicaid, Medicare, and commercial insurance billing
• Familiarity with electronic medical records (EMR) and billing software
• Strong attention to detail and organizational skills
• Excellent communication and problem-solving abilities

Preferred Skills

• Experience with platforms such as CentralReach, HHA Exchange, NJMMIS, Availity, Cyber or similar billing systems
• Knowledge of ABA, behavioral health, or community-based services billing
• Ability to manage multiple accounts and meet deadlines

Work Environment

• Office
• May require collaboration with clinical, administrative, and finance teams

Compensation

• Salary commensurate with experience
• Benefits may include health insurance, paid time off, and professional development opportunities

Sierra House offers a range of benefits to support the well-being and professional growth of part-time employees, which may include:

• Flexible Scheduling to support work-life balance
• Paid Sick Time in accordance with New Jersey state law
• Professional Development Opportunities, including training and certifications
• Mileage Reimbursement for work-related travel (if applicable)
• Access to Training Platforms and Continuing Education
• Opportunities for Advancement within the organization
• Participation in Staff Meetings, Trainings, and Team Activities

• English: Required – Full professional proficiency (spoken and written)

Candidates should be able to:

• Communicate clearly and professionally with clients, families, and staff
• Understand and document basic service or billing information