We are seeking an experienced, detail-driven Medical Biller – Dermatology to manage end-to-end revenue operations for a fast-paced dermatology practice. In this role, you will lead claim creation, code auditing, complex modifier validation, and aggressive denial resolution to maximize reimbursement.
The ideal candidate brings specialized expertise in general, surgical, and cosmetic dermatology billing, exhibits expert command over modifier applications, and possesses recent, hands-on experience using ModMed (Modernizing Medicine).
Working Environment & Core Schedule
- Schedule: Monday – Friday, 8:00 AM – 5:00 PM EST (US Eastern Standard Time)
- Core EHR/Billing System: ModMed (Modernizing Medicine / EMA)
- Camera-On Shift Requirement: Agreement and ability to maintain an active, camera-on presence throughout the entire 8-hour shift—required for efficiency, real-time communication, and seamless collaboration with the team of virtual assistants supporting the practice.
Top 3 Daily Tasks
- Dermatology Coding & Claim Auditing: Review and audit CPT, ICD-10, and HCPCS codes for medical, surgical, and cosmetic procedures prior to clearinghouse submission.
- Denials, Appeals & Reconsiderations: Investigate rejected or denied claims, correct coding/modifier errors, submit clean claims, and file formal appeals.
- Payer Follow-Up & Claims Resolution: Conduct proactive follow-up on unpaid or underpaid claims with commercial and government carriers to maintain cash flow.
Core Responsibilities
- Code Verification & Auditing: Audit provider documentation to verify CPT, ICD-10, and HCPCS coding for accuracy, medical necessity, and compliance before billing.
- Complex Modifier Application: Apply and audit specialty modifiers (e.g., 25, 59, XS, XE, XP, XU) to prevent bundling and procedure-to-procedure (PTP) denials.
- Denial Investigation & Resolution: Perform root-cause analysis on claim rejections, revise coding, attach necessary clinical documentation, and resubmit claims promptly.
- Appeals Management: Draft and submit formal reconsideration letters and clinical appeals for complex or high-value denials.
- ModMed Workflow Oversight: Navigate ModMed's billing queues, claim scrubbers, and ERA posting modules to keep practice A/R current.
- Collaborative Remote Team Engagement: Maintain active video connection throughout the shift to facilitate immediate communication, team syncs, and operational alignment with co-VAs.
Requirements
Required Qualifications
- Certification: CPB (Certified Professional Biller) or CBCS (Certified Billing and Coding Specialist) or CMRS (Certified Medical Reimbursement Specialist) Certification
- Specialty Billing Background: Proven medical billing experience specifically supporting a Dermatology practice.
- Dermatology Coding Command: Solid proficiency in dermatology-specific CPT, ICD-10, and HCPCS coding guidelines.
- Advanced Modifier Mastery: Deep, practical familiarity with complex dermatology modifiers (e.g., Modifier 25, 59, XS/XE/XP/XU).
- Claims & Denials Expertise: End-to-end experience submitting clean claims, troubleshooting rejections, and filing formal appeals.
- Camera & Workstation Compliance: Commitment to maintaining an active camera-on presence for the entire 8-hour shift in a private, quiet, HIPAA-compliant workspace.
- Remote Setup: Dedicated PC/Mac, high-speed internet connection, backup internet solution, and a clear USB headset.
Highly Preferred Qualifications
- Software Mastery: Hands-on experience using ModMed (Modernizing Medicine / EMA).
- Leadership Experience: Previous experience as a Billing Supervisor, Team Lead, or Senior Claims Specialist is a strong plus.
Ideal Candidate Profile
You are a sharp, analytical dermatology biller who knows ModMed inside and out. You understand how to read provider notes, catch bundling errors, apply X-modifiers with precision, and relentlessly pursue uncollected insurance claims until resolved.