Wound Care Biller

We are seeking a Certified Medical Biller with specialized experience in wound care, grafting/skin substitute billing, and Ultramist therapy. This role is responsible for accurate coding, claim submission, reimbursement optimization, and compliance with payer guidelines related to advanced wound care services. The ideal candidate is detail-oriented, highly knowledgeable in complex billing scenarios, and experienced in navigating payer-specific requirements. This role will support our transition from using a third-party billing service to building a strong in-house billing function. This position offers flexibility for part-time or full-time engagement based on candidate availability and organizational needs.

Key Responsibilities

• Prepare, review, and submit medical claims for wound care services, including:
• Debridement procedures
• Skin substitutes / graft applications
• Ultramist (non-contact low-frequency ultrasound) therapy
• Ensure accurate CPT, HCPCS, and ICD-10 coding specific to wound care and advanced treatments
• Verify documentation supports billed services and meets payer requirements
• Manage claim follow-up, denials, and appeals to ensure timely reimbursement
• Track and resolve billing discrepancies and underpayments
• Collaborate with clinical teams to ensure proper documentation for:
• Wound measurements, staging, and progression
• Medical necessity for grafts and advanced therapies
• Stay current on Medicare, Medicaid, and commercial payer policies related to wound care billing
• Maintain compliance with all regulatory and payer guidelines
• Generate billing, aging, and reimbursement reports as needed

Required Qualifications

• Active certification required (e.g., Certified Professional Biller (CPB), Certified Professional Coder (CPC), or equivalent)
• Minimum 1–2 years of medical billing experience, preferably in wound care or related specialty
• Strong knowledge of:
• Wound care billing and coding
• Skin substitutes / graft billing (Q-codes, modifiers, units)
• Ultramist therapy billing
• Familiarity with Medicare guidelines, LCDs, and documentation requirements for wound care
• Experience with EHR/EMR systems and billing software
• Ability to interpret clinical documentation and translate into billable services
• Strong attention to detail, organization, and problem-solving skills
• Excellent communication skills for working with providers and payers

Preferred Qualifications

• Experience with denial management and appeals specific to wound care claims
• Knowledge of revenue cycle management and payer audit processes

Work Location: Remote Pay: $35.00 - $40.00 per hour Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Vision insurance

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