Medical Biller

Power Health Colorado LLC; Greenwood Village (CO); Sur place; USD 42 000 - 65 000; Plein temps

Résumé du poste

Power Health Colorado is seeking a full-time Medical Biller to join our Revenue Cycle team. The role entails accurate and timely billing, payment posting, and aggressive follow-up to maximize reimbursement across workers’ compensation, personal injury, commercial insurance, and other payer types.

The successful candidate will own accounts from billing through resolution, work closely with providers and clinical staff, and support a multidisciplinary medical practice in a fast-paced environment

Qualifications

• Previous medical billing, revenue cycle, or healthcare A/R experience.
• Strong knowledge of CPT, ICD-10, modifiers, EOBs/ERAs and denials.
• Attention to detail and organizational skills.
• Ability to manage high-volume workload and prioritize accounts.
• Strong written and verbal communication skills.
• Comfort communicating with insurance carriers, adjusters, attorneys, patients, and internal staff.
• HIPAA compliance and patient confidentiality.

Responsabilités

• Review charges and submit claims in a timely manner.
• Verify CPT, ICD-10, modifiers, provider information, dates of service before submission.
• Identify missing or incomplete documentation that delays billing or payment.
• Submit corrected claims, reconsiderations, and appeals when necessary.
• Maintain accurate billing notes in the EHR/practice management system.
• Collaborate with providers and staff to resolve billing issues.
• Actively follow up on accounts receivable and payments.
• Identify unpaid, underpaid, or denials and address with carriers or parties.
• Follow Colorado WC billing requirements and prepare PARs when required.
• Coordinate on PI cases with case management and attorneys.
• Post payments accurately and reconcile accounts.
• Track denial trends and lead improvement efforts.
• Document all collection activity and results clearly.

Connaissances

Medical billing

Revenue cycle

A/R follow-up

CPT/ICD-10 knowledge

HIPAA compliance

Communication

EHR data entry

Outils

eClinicalWorks (eCW)

Description du poste

Department:Revenue Cycle / Billing
Employment Type:Full-Time
Reports To:Lead Biller / Operations Leadership
Company:Power Health Colorado (PHCO)

Position Summary

Medical Biller – Full-Time

Department:Revenue Cycle / Billing
Employment Type:Full-Time
Reports To:Lead Biller / Operations Leadership
Company:Power Health Colorado (PHCO)

Power Health Colorado is seeking a full-timeMedical Billerto join our Revenue Cycle team. This position is responsible for accurate and timely billing, payment posting, accounts receivable follow-up, denial management, and collection activities across a multidisciplinary medical practice.

PHCO treats patients acrossWorkers’ Compensation (WC), Personal Injury (PI), commercial insurance, and other applicable payer types. The ideal candidate is organized, accountable, detail-oriented, and comfortable working in a fast-paced environment where accurate billing and aggressive, appropriate follow-up directly impact the financial performance of the organization.

This is not simply a claim-entry position. The Medical Biller is expected to take ownership of assigned accounts from billing through resolution and collection.

Key Responsibilities

Billing & Claims

• Review charges and submit accurate claims in a timely manner.
• Verify CPT, ICD-10, modifiers, provider information, dates of service, and other claim information prior to submission.
• Identify missing or incomplete documentation that may delay billing or payment.
• Submit corrected claims, reconsiderations, and appeals when necessary.
• Maintain accurate billing notes and documentation within the practice management/EHR system.
• Work closely with providers, clinical staff, front office, and case management to resolve billing issues.

Accounts Receivable & Collections

• Actively work assigned A/R and follow up on outstanding balances.
• Identify unpaid, underpaid, denied, or incorrectly processed claims.
• Contact insurance carriers, adjusters, attorneys, funding companies, and other responsible parties as appropriate.
• Research payment discrepancies and pursue additional reimbursement when appropriate.
• Escalate aging or high-value accounts requiring additional intervention.
• Maintain clear documentation of all collection and follow-up activity.
• Work assigned accounts consistently until payment or appropriate resolution is obtained.

Workers’ Compensation

• Understand and follow Colorado Workers’ Compensation billing requirements and applicable fee schedules.
• Verify claim information, adjuster/carrier information, authorization status, and billing requirements.
• Assist with or submitPrior Authorization Requests (PARs)when required.
• Ensure supporting documentation, invoices, medical records, and other required materials are attached when necessary.
• Review WC payments for proper reimbursement and identify potential underpayments.
• Follow up directly with carriers and adjusters regarding unpaid or disputed balances.

Personal Injury

• Maintain accurate billing records for PI cases, including direct lien and other applicable arrangements.
• Coordinate with case management and attorneys regarding case status when necessary.
• Ensure bills and supporting documentation are available and submitted appropriately.
• Track outstanding PI balances and assist with settlement, reduction, or payment-related requests according to PHCO procedures.
• Maintain accurate financial information so leadership and case management have reliable visibility into outstanding balances.

Payment Posting & Reconciliation

• Accurately post insurance, patient, attorney, funding, and other payments.
• Apply contractual adjustments and other approved adjustments appropriately.
• Identify discrepancies between billed charges, expected reimbursement, and actual payment.
• Ensure payments are applied to the correct patient, claim, provider, and date of service.
• Assist with reconciliation and reporting as requested.

Denials & Appeals

• Review denials promptly and determine the root cause.
• Correct billing errors and resubmit claims when appropriate.
• Prepare appeals and provide supporting documentation.
• Track recurring denial trends and communicate systemic issues to leadership.
• Help identify opportunities to prevent future denials rather than repeatedly correcting the same issue.

Performance Expectations & KPIs

Performance will be evaluated using measurable Revenue Cycle outcomes, including:

• Clean Claim Rate:95%+
• Timely Claim Submission:95%+ of claims submitted within established PHCO standards
• Payment Posting Accuracy:98%+
• Denial Follow-Up:Initial action within 5 business days
• A/R Follow-Up:Assigned accounts worked according to established aging and priority standards
• A/R Aging:Consistent reduction of balances greater than 60 and 90 days
• Underpayment Identification:Timely identification and follow-up of reimbursement discrepancies
• Documentation:100% of collection and follow-up activity appropriately documented
• Productivity:Completion of assigned billing and A/R workload within established departmental expectations

The expectation is not simply to “touch” accounts.Accounts should move toward resolution and collection.

Qualifications

Required

• Previous medical billing, revenue cycle, or healthcare A/R experience.
• Working knowledge of CPT, ICD-10, modifiers, EOBs/ERAs, denials, and claim follow-up.
• Strong attention to detail and organizational skills.
• Ability to manage a high-volume workload and prioritize accounts appropriately.
• Strong written and verbal communication skills.
• Comfortable communicating with insurance carriers, adjusters, attorneys, patients, and internal staff.
• Ability to maintain patient confidentiality and comply with HIPAA requirements.

Preferred

• Experience withWorkers’ Compensation and/or Personal Injury billing.
• Knowledge of Colorado Workers’ Compensation billing and fee schedules.
• Experience with PARs, appeals, and authorization requirements.
• Experience witheClinicalWorks (eCW)or similar EHR/practice management systems.
• Experience working within a multidisciplinary medical practice.
• Bilingual English/Spanish is a plus.

What We Are Looking For

We are looking for someone who takes ownership of their work. The right person does not wait for an aging report to become a problem before taking action.

Successful PHCO billers are:

• Accountable and dependable
• Highly organized
• Detail-oriented
• Persistent with follow-up
• Comfortable asking questions and identifying problems
• Able to work independently while remaining part of a team
• Focused on bothaccuracy and collections
• Interested in improving processes instead of simply maintaining them

About Power Health Colorado

Power Health Colorado is a multidisciplinary healthcare organization providing coordinated medical and rehabilitation services across multiple Colorado locations. Our teams work collaboratively across medical, rehabilitation, case management, and revenue cycle functions to provide high-quality care while maintaining strong operational and financial standards.

Power Health Colorado is an Equal Opportunity Employer.