Medical Biller

Position Summary

Power Health Colorado (PHCO) is seeking a highly experienced Medical Biller with strong knowledge of personal injury (PI), workers’ compensation (WC), and commercial insurance billing. This role is critical to maintaining healthy revenue cycle performance and requires someone who is detail-oriented, accountable, and confident managing claims from submission through resolution.

The ideal candidate understands the nuances of med-legal billing, payer follow-up, and denial management, and can work collaboratively with case managers, front office, and clinical teams to ensure clean claims and timely reimbursement.

Key Responsibilities

Billing & Claims Management

• Submit accurate and timely medical claims (electronic and paper)

• Ensure proper CPT, ICD-10, and modifier usage

• Review documentation to confirm billing compliance

• Manage billing for PI, WC, and commercial insurance cases

• Handle lien-based and med-legal billing workflows when applicable

Accounts Receivable (A/R) Follow-Up

• Conduct proactive follow-up on unpaid or denied claims

• Identify root causes of denials and implement corrective actions

• Work aging reports and prioritize high-value claims

• Maintain clear documentation of payer communications

Denial Management

• Analyze denials and prepare appeals

• Coordinate with providers and case managers for required documentation

• Track trends and report recurring issues

Payment Posting

• Accurately post insurance and patient payments

• Reconcile EOBs and ERAs

• Identify underpayments and escalate when needed

Collaboration & Accountability

• Work closely with case management and front office to reduce billing errors

• Communicate clearly about missing information or documentation gaps

• Participate in team meetings and performance improvement initiatives

• Maintain HIPAA compliance and confidentiality at all times

Qualifications

Required

• 3+ years of medical billing experience

• Strong knowledge of CPT, ICD-10, HCPCS coding

• Experience with PI and/or workers’ compensation billing

• Proficiency in EHR/PM systems (e.g., eClinicalWorks or similar)

• Strong A/R follow-up and denial resolution skills

• High attention to detail and accuracy

• Professional communication skills

Preferred

• Experience in multi-disciplinary practices (PT, Chiro, PM&R, etc.)

• Familiarity with lien-based billing models

• Certification (CPB, CPC, or similar)

• Performance-driven mindset with measurable productivity standards

Success Metrics (KPIs)

• A/R days within target range

• Clean claim rate

• Denial rate reduction

• Timely follow-up productivity benchmarks

• Accurate payment posting rate

What We Value at PHCO

• Accountability over excuses

• Team-first mindset

• Continuous improvement

• Patient-centered approach

• Integrity and professionalism

Compensation & Benefits

• Competitive pay based on experience

• Benefits package (if applicable)

• Growth opportunities within PHCO