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Job description:

The Biller is responsible for reviewing, correcting, and resolving claim errors to facilitate the accurate and timely submission of claims to insurance carriers. Working under the direction of the Billing Lead, this position performs billing activities within assigned work queues, researches and corrects claim discrepancies, and ensures compliance with established standard operating procedures, payer requirements, and organizational policies. Success in this role requires strong attention to detail, organizational skills, and the ability to consistently follow documented processes.

Essential Duties and Responsibilities

• Apply established SOPs and payer-specific guidelines when resolving claim edits and rejections.
• Submit corrected claims within established productivity and quality standards.
• Document claim corrections, actions taken, and outcomes in accordance with departmental procedures.
• Monitor assigned work queues and prioritize tasks to meet required turnaround times.
• Identify recurring claim issues and communicate trends or concerns to the Billing Lead.
• Participate in training activities and process improvement initiatives.
• Collaborate with team members and other departments to obtain information necessary for claim resolution.
• Maintain compliance with HIPAA, payer requirements, and organizational policies regarding patient and billing information.
• Perform other duties as assigned

Education Requirements

• High School Diploma or equivalent required

Experience Requirements

• One year of medical billing, claims processing, revenue cycle, or related healthcare administrative experience preferred.
• Experience working claim edits, rejections, denials, or billing error queues preferred.
• Familiarity with commercial and other third-party payer requirements preferred.

Skills and Abilities

• Strong attention to detail with the ability to identify and correct data discrepancies.
• Excellent organizational and time-management skills.
• Ability to follow detailed SOPs, work instructions, and payer requirements consistently.
• Knowledge of medical billing terminology, claim processing, and insurance fundamentals.
• Ability to analyze claim edits, denials, and rejections and determine appropriate corrective action.
• Effective written and verbal communication skills.
• Ability to work independently and as part of a team.