Optimum RTS - Biller and Coder
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Biller and Coder

Location : Wellington
Job Type : Direct
Hours : Full Time
Required Years of Experience : 2+
Travel : No
Relocation : No
Job Industry : Healthcare - Health Services
Job Category : Healthcare - Other

Job Description :

We are looking for knowledgeable, biller and coder. ATHENA experience preferred. The ideal candidate will have a minimum of 2 years of medical billing experience - primary care and Dermatology.

Must be skilled in all of the following:

  • Post insurance and patient’s payments.

  • Reviews claim prior to submitting to the insurance carriers

  • Answer patient inquires on account status and charges

  • Obtain patient payments

  • Reviews information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information. Insures claim information is complete and accurate

  • Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 form

  • Answer patient questions on patient responsible portions, copays, deductibles, write-off’s, etc. Resolves patient complaints or explains why certain services are not covered.

  • Prepares patient statements for charges not covered by insurance. Insures statements are mailed on a regular basis.

  • Wok with patients to establish payment plan for past due accounts in accordance with provider policies.

  • Posts insurance and patient payments

  • May perform “soft” collections for patient past due accounts.

  • Prepares and submits secondary claims upon processing by primary insurer as needed

  • Follows HIPAA guidelines in handling patient information.

  • Understands managed care authorizations and limits to coverage such as the number of visits.

  • At times verify patient benefits eligibility and coverage.

  • Follows standard billing procedures

  • CPT and ICD-10 coding rules and guidelines

  • Claim denials

  • Deductible/Co-insurance determination

  • Un-postables

  • Familiarity with the claim processes of commercial payers

  • Fundamentals of Coding

  • Hospital Billing for specialty physicians who see patients in hospital setting


Candidates with CPC or CPB preferred. Must be able to work in the office, no remote work (exception with COVID restrictions). Prefer ATHENA  experience. Bilingual a plus and experience with Ezderm and Modernizing Modernizing Medicine also preferred.

Required Qualifications :
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