Medical Biller Job Description and Responsibilities

The Medical Biller plays a central role in a healthcare administration team, handling billing processes, claims submission and accounts receivable. Candidates with experience in healthcare billing or medical administration who are accurate, organised and comfortable communicating with patients and payers should apply.

Medical Biller Job Profile

The Medical Biller is responsible for preparing and submitting accurate patient invoices and insurance claims to ensure timely reimbursement for services rendered. The role requires close attention to clinical documentation, coding accuracy and adherence to regulatory and payer requirements.

This position supports revenue integrity by resolving billing discrepancies, managing denials and maintaining clear records of payments and outstanding receivables. The Medical Biller typically works within an office or clinical administration environment and collaborates with clinical and administrative colleagues.

Medical Biller Job Description

The Medical Biller prepares patient accounts, verifies insurance coverage and submits claims to private and public payers. The role involves reviewing clinical documentation to confirm billing codes, correcting coding or documentation issues and ensuring claims meet payer rules prior to submission.

In addition to claims submission, the Medical Biller monitors remittance advices and explanation of benefits, posts payments, reconciles accounts and pursues outstanding balances through follow-up and appeals where necessary. The role requires routine reporting on receivables, denial trends and recovery activity to support continuous improvement in billing performance.

Effective communication with patients, clinicians and payers is essential to resolve billing enquiries and discrepancies. The Medical Biller must maintain patient confidentiality, comply with data protection and regulatory requirements and contribute to process improvements that reduce errors and accelerate collections.

Medical Biller: Duties and Responsibilities

• Verify patient demographic and insurance eligibility prior to billing
• Review clinical documentation and apply appropriate billing codes such as ICD-10 and CPT
• Prepare, submit and monitor insurance claims for timely adjudication
• Post payments and adjustments to patient accounts accurately
• Investigate and resolve claim denials and rejections, including appeals where required
• Reconcile accounts receivable and follow up on outstanding balances
• Generate and send patient statements and manage patient billing enquiries professionally
• Maintain accurate records of billing activity and payment history
• Produce regular reports on billing metrics, denials and cash collection
• Liaise with clinical staff to obtain missing documentation or clarify charges
• Ensure compliance with billing regulations, payer policies and data protection requirements
• Identify process improvements to reduce billing errors and improve collection cycles
• Support audit requests and participate in corrective action related to billing issues

Medical Biller: Requirements and Qualifications

• Minimum of a secondary school certificate or equivalent; vocational qualification in medical billing or coding preferred
• Proven experience in medical billing, claims processing or healthcare administration
• Knowledge of ICD-10 and CPT coding principles and billing conventions
• Understanding of insurance verification, eligibility and payer rules
• Strong numerical accuracy and attention to detail
• Good written and verbal communication skills for interacting with patients and payers
• Ability to prioritise workload and manage multiple accounts to meet deadlines
• Experience in posting payments, reconciling accounts and handling denials
• High level of integrity and ability to maintain patient confidentiality
• Problem solving skills and the ability to follow established billing procedures
• Basic IT literacy and comfort learning billing systems and office software
• Ability to work independently and as part of a multidisciplinary team