Inpatient Medical Biller

Nexus Health Systems; Houston, Northern (TX, KY); Hybrid; USD 45,000 - 65,000; Full time

Job summary

Nexus Health Systems – Central Business Office seeks an Inpatient Medical Biller to accurately bill inpatient hospital claims to government and commercial payers. This role requires hospital billing experience, clearinghouse submissions, and code knowledge to ensure timely reimbursement.

The ideal candidate will review documentation, resolve claim edits, and collaborate with facility staff to maintain compliant claim submissions while supporting ongoing revenue cycle improvements.

Qualifications

• Minimum of one year of inpatient hospital medical billing experience.
• Experience submitting claims through an electronic clearinghouse.
• Knowledge of hospital billing processes and revenue cycle operations.
• Strong understanding of medical billing codes, payer requirements, and claim submission guidelines.
• Experience billing Medicare, Medicaid, managed care, commercial insurance, and out-of-state payers.
• Excellent attention to detail and organizational skills.
• Proficiency with electronic medical records and billing software.

Responsibilities

• Prepare, review, and submit inpatient hospital claims for Medicare, Medicaid, managed care, and commercial payers.
• Submit claims electronically and monitor acceptance and rejections.
• Review patient accounts and documentation for completeness and compliance.
• Verify documentation supports timely reimbursement.
• Research and resolve claim edits and rejections for clean submissions.
• Collaborate with facility staff to obtain supporting documentation.
• Identify billing trends and suggest process improvements.
• Maintain compliance with federal, state, and payer regulations.
• Assist with additional revenue cycle responsibilities as assigned.

Skills

Attention to detail

Organizational skills

Communication skills

Problem-solving

Billing software

Electronic Medical Records

Education

Associate degree in Healthcare Administration

Tools

Billing software

Electronic Medical Records

Job description

Full Time Clerical Houston, TX, US

30+ days ago Requisition ID: 2143

Inpatient Medical Biller

Location: Nexus Health Systems – Corporate (Houston, TX)
Department: Central Business Office (CBO)
Employment Type: Full-Time

Join Our Revenue Cycle Team

Nexus Health Systems is seeking an experiencedInpatient Medical Biller to join our Central Business Office. This role is responsible for the accurate and timely billing of inpatient hospital claims to government and commercial payers. We are looking for a highly detail-oriented professional with experience in hospital billing, electronic claim submission, and navigating payer-specific billing requirements.

This is amedical billing position—not a collections role. The ideal candidate has hands-on experience submitting claims through a clearinghouse, understands hospital billing codes and claim requirements, and has successfully billed both in-state and out-of-state payers.

• Prepare, review, and submit accurate inpatient hospital claims for Medicare, Medicaid, managed care, and commercial insurance payers.
• Submit claims electronically through a clearinghouse and monitor claim acceptance, edits, and rejections.
• Review patient accounts and billing documentation to ensure claims are complete, accurate, and compliant prior to submission.
• Verify all required documentation is present to support timely reimbursement.
• Research and resolve claim edits and rejections to ensure clean claim submission.
• Coordinate corrected claims and rebills as needed.
• Monitor electronic claim status to confirm payer receipt and acceptance.
• Utilize medical billing codes and payer-specific guidelines to ensure billing accuracy.
• Bill claims for both in-state and out-of-state payers while adhering to payer-specific requirements.
• Maintain accurate documentation within patient accounts and billing systems.
• Collaborate with facility staff and internal departments to obtain supporting documentation for claim submission.
• Identify billing trends or process issues that could impact reimbursement and recommend improvements.
• Maintain compliance with all federal, state, and payer billing regulations.
• Assist with additional revenue cycle responsibilities as assigned.

Qualifications

Required

• High school diploma or equivalent.
• Minimum of one (1) year of inpatient hospital medical billing experience.
• Experience submitting claims through an electronic clearinghouse.
• Knowledge of hospital billing processes and revenue cycle operations.
• Strong understanding of medical billing codes, payer requirements, and claim submission guidelines.
• Experience billing Medicare, Medicaid, managed care, commercial insurance, and out-of-state payers.
• Exceptional attention to detail and organizational skills.
• Strong communication and problem-solving abilities.
• Proficiency with electronic medical records and billing software.

Preferred

• Associate degree or college coursework in Healthcare Administration, Business, or a related field.
• Experience with UB-04 claims, electronic remittance advice (ERA), and EDI transactions.
• Experience billing for inpatient rehabilitation, behavioral health, long-term acute care, or specialty hospitals.
• Knowledge of denial prevention and clean claim best practices.

Why Join Nexus Health Systems?

At Nexus Health Systems, our Central Business Office plays a critical role in supporting exceptional patient care by ensuring accurate and timely reimbursement. As an Inpatient Medical Biller, you'll join a collaborative team committed to operational excellence, compliance, and continuous improvement while supporting hospitals that provide specialized care to patients with complex medical and behavioral needs.