Role Description
This role requires a detail-oriented and proactive Medical Billing Associate to support billing and reimbursement operations for our Independent Diagnostic Testing Facility (IDTF). This role plays a critical part in ensuring accurate and timely billing for cardiac diagnostic services, including data derived from wearable and ambulatory cardiac monitoring devices.
The ideal candidate has hands-on experience with medical billing workflows, payer requirements, and denial resolution—particularly in cardiology or diagnostic testing environments—and is comfortable working with clinical data, device-generated reports, and physician orders.
Key Responsibilities
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Billing & Claims Management
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Prepare, review, and submit professional and technical claims for cardiac diagnostic services in compliance with payer, CMS, and IDTF regulations.
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Ensure accurate CPT, HCPCS, ICD-10, and modifier usage related to cardiac monitoring and diagnostic testing.
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Validate completeness of physician orders, patient demographics, insurance eligibility, and supporting documentation prior to claim submission.
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Revenue Cycle Support
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Monitor claim status, identify delays, and follow up with commercial payers, Medicare, and Medicaid as needed.
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Research, analyze, and resolve claim denials, rejections, and underpayments; submit appeals with supporting documentation.
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Post payments, adjustments, and denials accurately and in a timely manner.
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Compliance & Quality
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Maintain compliance with CMS, HIPAA, and IDTF billing requirements.
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Identify trends in denials or reimbursement issues and proactively escalate concerns to leadership.
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Support internal and external audits by providing requested billing documentation and explanations.
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Cross-Functional Collaboration
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Work closely with clinical operations, device/data teams, and customer support to resolve billing discrepancies.
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Communicate professionally with providers' offices and patients regarding billing questions, when needed.
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Assist with process improvements to increase billing accuracy, turnaround time, and collections.
Qualifications
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2+ years of experience in medical billing, revenue cycle, or claims processing.
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Working knowledge of CPT, ICD-10, HCPCS coding and medical billing workflows.
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Experience billing Medicare and commercial payers.
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Strong attention to detail and ability to manage high volumes of claims accurately.
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Proficiency with billing systems, EHRs, or practice management platforms - NextGen preferred.
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Comfortable working in a fast-paced, regulated healthcare environment.
Preferred Qualifications
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Experience in cardiology, cardiac monitoring, diagnostics, or IDTF environments.
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Familiarity with ambulatory cardiac monitoring codes and workflows (e.g., Holter, patch monitors, event monitors).
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Experience with denial management and appeals.
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CPC, CPB, or similar billing/coding certification.
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Prior experience working with a remote or distributed team.
Compensation
This is a salaried role starting at $43,000 annually and up, DOE.
Benefits
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Optional Remote work opportunity.
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401(k).
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Dental insurance.
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Health insurance.
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Vision insurance.
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Life insurance.
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Paid time off.