Supervision Received

This position reports directly to the Revenue Cycle Director. This is a full time non-exempt hourly position.

Position Summary

As a Medical/Dental Biller, your primary responsibility is to manage the financial aspects of the medical office.  You will work closely with patients, insurance companies, and other administrative staff to ensure accurate and timely billing and payment processing. Your role involves understanding medical and dental insurance policies, coding procedures, and billing regulations to facilitate smooth financial operations within the practice. Attention to detail, strong organizational skills, and excellent communication abilities are essential for success in this role.

Job Duties and Responsibilities

• Insurance Verification: Verify patients’ insurance coverage and eligibility prior to appointments. Ensure accurate information is obtained and recorded in the billing system
• Billing and Coding: Proficiency in dental coding terminology (e.g., CDT codes) and billing software applications.  Assign appropriate billing codes to dental procedures performed using the standardized coding system (e.g., CDT codes). Ensure adherence to coding guidelines to prevent errors and maximize reimbursement.

• Claims Submission: Prepare and submit insurance claims electronically or through paper submission. Monitor claim status and follow up on any rejections or denials. Make necessary corrections and resubmit claims promptly.
• Payment Processing: Receive and process payments from patients and insurance companies. Post payments accurately to patient accounts and reconcile any discrepancies.
• Patient Billing: Generate and send out patient statements for outstanding balances. Assist patients with understanding their bills, explaining insurance coverage, and setting up payment plans if necessary.
• Appeals and Denials Management: Handle insurance claim denials and appeals. Investigate reasons for denials, gather supporting documentation, and resubmit claims with additional information as needed.
• Record Maintenance: Maintain organized and up-to-date billing records, including patient demographics, insurance information, and billing history. Ensure confidentiality and compliance with HIPAA regulations.
• Communication: Liaise with patients, insurance companies, and other healthcare providers to resolve billing inquiries and disputes promptly. Provide excellent customer service and address concerns professionally.
• Revenue Cycle Management: Assist in optimizing the revenue cycle by identifying opportunities for process improvements, reducing claim rejections, and accelerating payment collection.

• Follows internal policies and procedures.
• Complies with OSHA regulations and HIPPA.
• Excellent verbal and written communication skills.
• Must have ability to exercise sound judgement and discretion.
• Ability to maintain highly confidential information.
• Other duties as assigned.
• Bilingual preferred.

Required Qualifications, Education, and Experience

Knowledge, skills and abilities:

• Must have knowledge of working in a nonprofit health organization.
• Thorough understanding of ICD 10; CDT & CPT codes and guidelines as well as all private Insurances.
• Must possess excellent verbal and written communication skills.
• Attention to detail.
• Must possess excellent customer service and interpersonal skills.
• Must have the ability to work independently and in a team setting with minimal supervision.
• Must have attention to detail and accuracy; be flexible and adaptable to changing situations.
• Must be able to interact positively and respectfully with colleagues, supervisors, and community.
• Must pass background and fingerprint checks.
• Must possess strong computer skills, including a working knowledge of MS Office Suite.
• Must speak, read, and write fluent English and Spanish.
• High School Diploma or equivalent, required.
• Billing Certification preferred.

The above statements are intended to describe the general nature and level of work being performed by personnel assigned to this classification.  They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.  Job duties to be performed with or without reasonable accommodations.

FirstMed is proud to be an Equal Opportunity Employer. FirstMed is committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce.

In compliance with the Americans with Disabilities Act, FirstMed will provide reasonable accommodations to qualified individuals with disabilities and encourages candidates and employees to advise if they believe they need accommodation. If you need assistance applying for this position, require a reasonable accommodation, or have other questions, please send a message to [email protected].