The Medical Biller is responsible for managing end-to-end Revenue Cycle Management (RCM) for anesthesia practices, including services for surgical, procedural, and perioperative care.
The primary focus will be on full-cycle RCM including benefit and eligibility verification (BNE), prior authorizations, patient inbound calls, payment posting, denial management, AR follow-ups, collections, and appeals, to ensure timely reimbursement and overall financial health of the practice.
This role works closely with anesthesiologists, surgeons, providers, payers, and patients to maintain compliance, improve collections, and support sustainable revenue growth
Revenue Cycle Management – End-to-End
- Manage the full billing lifecycle for anesthesia services, including benefit verification, eligibility checks, prior authorizations/utilization review, charge entry, clean claim submission, payment posting, AR follow-ups, denial management, appeals, and patient collections.
- Ensure timely and accurate claim submission to all payers, adhering to anesthesia-specific payer guidelines, authorization rules, and filing limits.
- Review clinical documentation to ensure medical necessity, correct coding, and compliance.
- Apply correct CPT, ICD-10, HCPCS codes, and modifiers specific to anesthesia (e.g., time-based anesthesia codes, surgical modifiers, ASA modifiers).
- Utilize multiple EHR/EMR and Practice Management (PM) systems efficiently.
- Proactively follow up on unpaid, underpaid, or denied anesthesia claims.
- Perform root-cause analysis on denials and submit timely and well-documented appeals.
- Prepare, reconcile, and distribute accurate patient statements.
- Monitor AR aging reports and work assigned buckets to resolution to reduce AR days and improve cash flow.
Claims Management & Accounts Receivable (AR)
- Track and capture anesthesia services, including procedural, surgical, and perioperative care.
- Verify patient demographics, insurance eligibility, benefits, and authorization requirements prior to claim submission.
- Demonstrate a thorough understanding of AR reporting, prioritizing work based on aging, payer behavior, and reimbursement risk.
- Identify trends in anesthesia denials and recommend corrective actions.
Financial Coordination & Reconciliation
- Reconcile patient and payer accounts and maintain organized billing and financial records.
- Accurately post ERA/EOB payments, adjustments, write-offs, and refunds.
Manage patient balances, payment plans, and outstanding receivables. - Generate monthly and ad hoc billing and financial reports for leadership review.
Provider, Patient & Insurance Coordination
- Communicate effectively with anesthesiologists, surgeons, and clinical leadership regarding documentation gaps, coding clarifications, and authorization requirements.
- Coordinate with insurance payers, clearinghouses, and portals for claim status, eligibility, and benefit clarification.
- Communicate professionally with patients and clients, including handling inbound calls related to statements, benefits, authorizations, and balances.
EDI, ERA & Payment Processing
- Demonstrate working knowledge of EDI and ERA workflows, including anesthesia claim submission and remittance processing.
- Manage and maintain EFT enrollments with payers.
- Ensure accurate reconciliation between ERA/EOBs and posted payments.
Compliance & Reporting
- Maintain HIPAA compliance and adherence to anesthesia-specific payer, state, and federal regulations.
- Generate and analyze RCM performance reports, including AR aging, denial trends, authorization compliance, and reimbursement metrics.
- Identify workflow gaps and recommend process improvements and best practices for anesthesia billing operations.
Key Qualifications:
- 5–8+ years of hands-on experience in Revenue Cycle Management, with strong exposure to anesthesia billing.
- Proven experience working with multiple EHR, EMR, and PM systems.
- Strong proficiency with payer/EDI portals (e.g., Availity, Change Healthcare).
- Solid understanding of:
- Anesthesia CPT, ICD-10, and HCPCS coding
- Modifier usage and corrections (time-based anesthesia codes, surgical modifiers)
- Medical necessity and documentation requirements
- Denial management, appeals, and AR follow-ups
- Benefits verification and prior authorizations
- EDI/ERA processing and EFT enrollments
- Experience with US payers (Commercial, Medicare, Medicaid).
- Strong written and verbal English communication skills, especially for appeals, payer correspondence, and patient-facing communication.
- High level of accuracy, attention to detail, and ability to work independently.
- College degree or equivalent experience; Healthcare Administration or related field preferred.
Shift / Hours:
Monday – Friday in one single shift, anytime during the hours of 9:00 AM EST – 6:00 PM EST. Note this is +12 or +13 Philippine time, which will be 9:00 PM PHT – 6:00 AM in PHT outside of Daylight Savings Time and 10:00 PM PHT – 7:00 AM PHT.
Business Overview:
The company provides a variety of services for new and existing medical practices and has a current physician roster of ~2,500. The company works with medical practices in a variety of specialties, including counseling, behavioral health, podiatry, pediatrics, urgent care, neurology, family practices, orthopedics, PT, OT, ST and others.
They have clients in all 50 states with a focus in CA, NY, TX, FL, IL, CO, Or and WA. They focus on 3 main areas: Medical, Behavioral and Dental.
Location: Jacksonville, FL