We are seeking a detail-oriented Medical Biller / AR Specialist to join a dynamic healthcare team. This role is responsible for accurate and timely medical claims processing, efficient reimbursement support, and compliance with healthcare regulations. The position works closely with healthcare providers, insurance companies, and patients to manage billing and revenue cycle activities that support the financial health of the organization.
Key responsibilities include:
- Reviewing a high volume of claims to ensure billing guidelines are met.
- Submitting electronic claims accurately and on time.
- Sending claims to secondary insurance with appropriate supporting documentation.
- Reviewing EOB denials and underpayments to determine the best next step, including resubmission or appeals.
- Following up on claims status through insurance portals and phone calls.
- Performing verification of benefits and obtaining authorizations when required.
- Maintaining productivity and quality standards set by management.
- Adhering to HIPAA and PHI guidelines.
Requirements & Qualifications
Qualifications and preferred experience include:
- Knowledge of medical terminology, CPT codes, ICD-10 codes, and modifiers.
- Experience with commercial insurance, Medicare, and Medi-Cal.
- Knowledge of EOBs and ERAs.
- Excellent communication and analytical skills.
- Strong attention to detail and organizational skills.
- Toxicology billing experience is a plus.
- Medical billing certification is a plus.
- Coding experience is a plus.
Location
Irvine, California, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
4 weeks ago
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