The Medical Billing Specialist supports accurate and timely billing for services provided at a long-standing nonprofit treatment provider. This role handles claim preparation, submission, follow-up on denied or unpaid claims, compliance with billing regulations, and coordination with clinical and agency partners to support clean claims and reimbursement.
Key responsibilities include:
- Reconciling billing records for accuracy, including authorizations, eligibility, diagnoses, and modifiers
- Reviewing daily billing reports and flagging discrepancies
- Conducting monthly audits of billable claims for compliance
- Submitting claims and following up on outstanding or denied submissions
- Working with the Billing Supervisor to resolve audit findings and claim issues
- Coordinating with agencies on reimbursement and documentation concerns
- Partnering with the Clinical Department to verify service documentation
- Maintaining admissions tracking for new clients, discharges, and status updates
- Monitoring authorization requests and extensions
- Reviewing group counseling and education session logs for billing accuracy
- Using EHR systems such as PCNK and MyEvolv for billing activities
- Staying current on Title 22, Title 9, and DMC Provider Manual guidelines
Requirements & Qualifications
- High school diploma or GED required
- Medical Billing Certificate preferred, or equivalent experience
- Minimum 3 years of hands-on medical billing experience required
- At least 1 year of experience with SAPC DMC-ODS billing system preferred
- Experience handling denied claims, auditing, and billing corrections
- Knowledge of medical billing and coding, including ICD-10, CPT, and HCPCS
- Understanding of claims processing and revenue cycle workflows
- Proficiency with EHR/EMR systems
- Strong Microsoft Excel skills
- Excellent organization and time management skills
- Clear written and verbal communication skills
- Basic math skills
- Ability to collaborate effectively with teams and external agencies
Benefits & Perks
- Medical insurance
- Dental insurance
- Vision insurance
- 401(k)
- Growth opportunities
Location
Los Angeles, California, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 week ago