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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare billing processes, including claim submission, payment posting, and reconciliation, while ensuring compliance with payer guidelines and internal policies. Proficient in utilizing healthcare practice management systems and coding standards to achieve operational efficiency and accuracy.
Highest-signal resume keywords
Healthcare Billing ExperienceCPT, ICD-10, HCPCS Coding KnowledgeEHR Systems ProficiencyClaim Submission and Rejection ResolutionCertified Professional Biller (CPB)
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claim SubmissionPayment PostingCharge EntryRejection CorrectionPayment ReconciliationModifier ValidationDenial ManagementAudit AssistanceAR ManagementCompliance with HIPAA
Soft Skills
Attention to DetailOrganizational SkillsTime ManagementCollaborative MindsetProcess Orientation
Tools & Technologies
EpicAthenaNextGenECWNymbl
Certifications & Qualifications
Certified Professional Biller (CPB)
Industry Keywords
Medicare BillingMedicaid BillingCommercial Insurance BillingPatient Account BalancesEOB Interpretation
About the role
Key responsibilities & impact- Prepare, review, and submit professional and/or institutional claims to commercial, Medicare, and Medicaid payers
- Transmit electronic and paper claims to primary, secondary, and tertiary payers for multiple patient-care locations
- Verify claim acceptance and correct clearinghouse or payer rejections
- Resolve claim edits and rejections before payer submission
- Validate modifiers and payer-required claim elements against documentation
- Complete charge entry, claim submission, rejection correction, and payment posting within service-level standards
- Post payments and adjustments from EOBs, ERAs, and patient payments
- Reconcile payments against contractual allowances and fee schedules
- Identify and route underpayments, overpayments, denials, unapplied cash, credit balances, and discrepancies
- Apply authorized adjustments and write-offs with approved reason codes and documentation
- Maintain accurate patient account balances
- Collaborate with coding, front-office, and AR teams to resolve billing issues
- Maintain compliance with payer guidelines, HIPAA, and internal billing policies
- Assist with audits, reconciliations, month-end close, AR management, denials management, and patient and payer collections as needed
- Maintain collection activity records and account documentation
- Assist with routine AR reporting and reconciliation activities
- Achieve company targets for days to bill, clean claim rate, denial rate, and payment and denial posting timelines
Requirements
What you’ll need- High school diploma or equivalent
- 2+ years of healthcare billing and payment posting experience
- Working knowledge of CPT, ICD-10, and HCPCS coding
- Experience with Medicare, Medicaid, and commercial insurance billing
- Proficiency in healthcare practice management or EHR systems (e.g., Epic, Athena, NextGen, eCW, Nymbl)
- High attention to detail and accuracy
- Strong organizational and time-management skills
- Ability to interpret EOBs and payer remittance data
- Collaborative, process-oriented mindset
- Certified Professional Biller (CPB) or similar certification preferred
- Experience with multi-specialty or high-volume billing environments preferred
Benefits
Comp & perks- Tailored onboarding and a buddy system
- Continuous learning through e-learning, training, and language courses
- Competitive Compensation Packages
- Medical, Dental, and Vision Benefits
- 401(k) Retirement Plan with employer matching contribution
- 8 paid holidays
- 13 vacation days, birthday and two (2) volunteer days
- 8 sick days within your first year of employment
- Paid Parental Bonding
- Remote or hybrid work depending on organizational needs
