Job Description

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Role:

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Report To:

Medical Biller/Coder



Chief Business Officer



Department: Operations


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Job Code:

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Full-Time

Location: Hybrid (mostly remote but must be able to reliably commute to HQ)



Salary Range: $63,000-$68,000


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About the Job

Essential Functions of the Medical Biller



Crandell's Enterprises Inc (CEI) is North Carolina's #1 group home health care company, is currently searching for a Medical Biller to be part of our Operations team.



The Medical Biller is responsible for preparing, submitting, and managing medical claims to insurance companies and patients. This role ensures accurate billing, timely payments, and



proper documentation of healthcare services rendered. The Medical Biller works closely with healthcare providers, insurance representatives, and patients to resolve billing discrepancies and



maintain compliance with all federal and state regulations.


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Key Responsibilities:

Prepare and submit medical claims to insurance companies (electronic and paper). Review and verify patient information, insurance coverage, and coding accuracy. Follow up on unpaid or denied claims to ensure prompt resolution and reimbursement. Post payments, adjustments, and denials to patient accounts accurately. Communicate with insurance companies regarding claim status, coverage issues, and appeals. Generate and send patient statements and assist patients with billing inquiries. Maintain confidentiality and compliance with HIPAA and other applicable regulations. Collaborate with coding staff and clinical teams to correct errors and ensure proper claim submission. Understanding of 835 and 837 files for direct Medicaid billing Prepare and maintain billing reports, aging summaries, and collections documentation. Stay updated on changes in insurance policies, billing regulations, and reimbursement

procedures.


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Qualifications:

5+ years of experience in medical billing, healthcare reimbursement, or related fields Knowledge of CPT, ICD10, and HCPCS coding Certification as a Medical Biller by AAPC, AMAB, or other Proficiency in medical billing software (e.g., Lauris, Kareo, eClinicalWorks, Athena, or similar) Strong attention to detail, organization skills, and problemsolving ability Proficient in Excel or similar application Exceptional Communication, both verbal and written
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Preferred Skills:

Ability to work independently and manage multiple tasks efficiently. Experience with Medicare, Medicaid, and commercial insurance billing. Understanding of EOBs (Explanation of Benefits) and AR (Accounts Receivable) processes. Familiarity with electronic health records (EHR) system Knowledge and understanding of credentialing
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All are welcome!

CEI values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any



protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply.


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EEO Statement

Our facility provides equal employment opportunities. We are committed to complying with all state, federal, and local laws that prohibit discrimination in employment, including recruitment, hiring, placement,



promotion, transfers, compensation, benefits, training, programs, reductions in workforce, termination, and recall. Our facility strives to provide equal opportunity for employment to all individuals who are properly



qualified and able to perform the duties of their employment, without regard to employees' legally-protected characteristics ("protected class") including: age, sex, race, color, creed, religion, national origin, ancestry,



citizenship, marital status, pregnancy, medical condition, physical or mental disability, sexual orientation, gender identity, sex stereotyping, or genetic information.


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About Crandells Enterprises Inc

Crandell's Enterprises Inc., offers a unique combination of premier home health care for individuals suffering from mental disorder, substance abuse and development disabilities. Founded in 2002 by CEO Mary Ann Crandell, the mission is to ensure their adult patients who suffer from mental illness, developmental disabilities and chemical dependence, have the resources, medical treatment and housing they need. The services offered range from adult family care to home psychiatric assistance and mental health services.