EMC Biller

Position Summary

The EMC (Electronic Media Claims) Biller is responsible for the accurate and timely electronic submission of medical claims to commercial and government payers on behalf of our provider clients. This role sits within the Central Business Office and owns the front end of the revenue cycle — clean claim submission, clearinghouse management, rejection resolution, and rebilling — with the goal of maximizing first-pass acceptance rates and minimizing days in A/R.

Key Responsibilities

• Prepare, review, and electronically transmit primary, secondary, and tertiary claims to Medicare, Medicaid, managed care, and commercial payers through the clearinghouse and payer portals.
• Scrub claims prior to submission for accurate patient demographics, insurance information, CPT/HCPCS codes, ICD-10 diagnosis codes, and modifiers.
• Monitor daily clearinghouse and payer acceptance/rejection reports; research, correct, and resubmit rejected claims within established turnaround times.
• Work claim edits and front-end denials, identifying root causes and escalating recurring issues to the Billing Supervisor.
• Post and reconcile electronic remittance advice (ERA/EOB) as assigned, and coordinate with the payment posting and A/R teams on variances.
• Generate and submit paper claims (CMS-1500 / UB-04) for payers that do not accept electronic submission.
• Maintain payer enrollment and EDI/ERA setup documentation; assist with new payer connectivity and testing as needed.
• Track and report daily productivity, claim volumes, and rejection trends.
• Respond to internal and provider-office inquiries regarding claim status.
• Maintain strict confidentiality and full compliance with HIPAA, payer requirements, and company policies.

Required Qualifications

• High school diploma or equivalent; associate's degree or medical billing certificate preferred.
• 2+ years of hands-on medical billing experience with an emphasis on electronic claim submission.
• Working knowledge of CPT, HCPCS, ICD-10, modifiers, and CMS-1500/UB-04 claim forms.
• Experience with clearinghouse platforms (e.g., Availity, Waystar, Change Healthcare/Optum, Trizetto).
• Familiarity with New York Medicaid, Medicare, and major commercial payer billing requirements.
• Proficiency with practice management / EHR systems and Microsoft Excel.
• Strong attention to detail, follow-through, and the ability to manage high claim volume against daily deadlines.
• Clear written and verbal communication skills.

Preferred Qualifications

• Experience in a centralized business office or multi-provider/multi-specialty billing environment.
• CPB, CPC, or comparable billing/coding certification.
• Prior exposure to denial management and A/R follow-up.

Physical & Work Requirements

• On-site position; standard office environment.
• Extended periods of computer and telephone work.

Pay: $23.00 per hour

Expected hours: 40.0 – 45.0 per week

People with a criminal record are encouraged to apply

Ability to Commute:

• Tarrytown, NY 10591 (Required)

Work Location: In person