Job Title: Rural Health Clinic Biller
Location: Erie County, Pennsylvania (In-person)
Position Type: Full-Time
Reports To: Office Manager
About Us:
We are a patient-focused Rural Health Clinic committed to providing high-quality primary care services to our local community. Our team values integrity, accuracy, and exceptional patient service. We are seeking a detail-oriented and motivated Rural Health Clinic Biller.
Position Summary
The Rural Health Clinic Biller is responsible for the accurate and timely processing of medical claims, insurance billing, revenue cycle tasks, and follow-up on unpaid or denied claims in compliance with regulatory and payer requirements. This role supports financial operations and ensures proper reimbursement for services provided.
Key Responsibilities
- Prepare, submit, and monitor claims to commercial, Medicare, and Medicaid payers on a daily basis.
- Verify and update patient insurance eligibility, demographic data, and coverage information.
- Review Explanation of Benefits (EOBs) and remittance advice for accuracy.
- Research, correct, and resubmit denied or rejected claims; perform denial management and appeal as needed.
- Post payments, adjustments, credits, and write-offs in billing/EHR systems.
- Communicate with patients, insurance companies, and internal staff regarding billing questions and account inquiries.
- Maintain accurate account balances and ensure compliance with HIPAA and payer billing guidelines.
- Assist with accounts receivable (A/R) follow-up and support revenue cycle improvement efforts.
- Support other revenue cycle and clinic administrative tasks as assigned.
Required Qualifications
- High School Diploma or GED (Associate’s degree or medical billing/health information certification preferred).
- 1–3+ years of medical billing experience in a clinic, medical practice, or healthcare setting; Rural Health Clinic experience strongly preferred.
- Knowledge of medical terminology, CPT, ICD-10, and HCPCS coding systems.
- Experience with electronic health records (EHR) and billing software systems.
- Strong attention to detail, analytical skills, and ability to work independently.
- Excellent communication skills, both verbal and written, with patients and third-party payers.
- Understanding of Medicare/Medicaid billing procedures and payer regulations.
Preferred Qualifications
- Certification (e.g., CPC, CPB, CMRS) is preferred but not required.
- Prior experience with payer follow-up, aged A/R workflows, and insurance appeals.
- Familiarity with Rural Health Clinic billing guidelines and encounter-based billing strongly preferred, or FQHC experience also preferred.
Working Conditions
- Full-time schedule (typically Monday–Friday, 8:00 AM-4:30 PM, may include occasional extended hours).
- Office environment within a clinical setting.
- Position requires handling sensitive patient and financial data with confidentiality and professionalism.
Compensation & Benefits
- Competitive pay (commensurate with experience)
- Health, dental, and vision insurance
- Retirement savings plan
- Paid time off and holidays
- Professional development opportunities
Work Location: In person
