Billing Associate

Job Description

Job Summary:
The Medical Billing Associate is responsible for creating and processing accurate medical bills and claim forms (including HCFA/CMS-1500), ensuring compliance with payer requirements and coding standards. The role requires strong knowledge of CPT and ICD-10 codes, attention to detail, and an understanding of healthcare billing workflows to ensure timely and accurate claim submission and reimbursement.

Key Responsibilities:

1. Prepare and generate accurate medical bills and HCFA (CMS-1500) claim forms based on patient encounters and medical documentation.
2. Review and validate patient demographics, provider details, insurance information, and service codes before claim creation.
3. Apply correct CPT, ICD-10, and HCPCS codes to ensure claims meet payer requirements.
4. Verify claim accuracy and completeness prior to submission to clearinghouses or payers.
5. Identify and correct billing errors to minimize claim rejections or denials.
6. Coordinate with the coding, charge entry, and AR teams to ensure accurate and timely billing.
7. Maintain compliance with HIPAA, CMS, and payer-specific billing regulations.
8. Assist in claim resubmissions, adjustments, and appeals when necessary.
9. Maintain organized billing records and documentation for audit and reporting purposes.

Qualifications and Requirements:

1. Bachelor’s degree in Commerce, Healthcare Administration, or a related field (preferred).
2. 1–3 years of experience in U.S. medical billing or revenue cycle operations.
3. Proficiency in preparing HCFA/CMS-1500 claim forms and using billing software (e.g., Kareo, AdvancedMD, eClinicalWorks, Athenahealth, or similar).
4. Understanding of CPT, ICD-10, and HCPCS coding systems.
5. Excellent attention to detail, analytical ability, and organizational skills.
6. Good communication and coordination skills for working with cross-functional teams.
7. Ability to work independently and meet deadlines in a fast-paced environment.

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