Medical Biller

• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity & Excellence 
• Be Innovative
• Work As One Team

What You'll Do

• Ensures accounts are billed accurately and timely by providing oversight and direction to Billing staff.
• Maintain current knowledge of billing systems and payor systems, including applicable federal/state laws, regulations, and third-party reimbursement policies and practices.
• Update trackers and live spreadsheets of billing progress and project deadlines
• Claim submission: Prepare and submit claims to insurance companies using billing software.
• Insurance verification: Verify patient insurance information, eligibility, and benefits.
• Payment and invoicing: Process payments, generate invoices for patients, and manage payment plans.
• Claims management: Follow up on denied or unpaid claims, resolve discrepancies, and handle appeals.
• Record keeping: Maintain accurate patient and billing records and ensure compliance with regulations.
• Project coordination: Assist in organizing project activities, schedules, and tasks to ensure timely completion.
• Documentation: Prepare and maintain project documentation, such as plans, budgets, and status reports.
• Performs other duties as assigned.

Qualifications

• High school diploma or GED equivalent
• 3+ years of medical billing experience required 
•  Experience supporting Quality/Risk Adjustment initiatives (HCC, RAF, gap closure) preferred 
• Familiarity with Quality measures (HEDIS/Stars) 
• Medical billing course certificate or coding certificates a plus
• Demonstrated strong knowledge of commercial and/or regulatory claims billing including relevant Federal, State, and local laws and regulations and requirements.
• Strong knowledge of third-party reimbursement, government reimbursement regulations, third party and patient billing, managed care agreements, account follow-up, account resolution, and cash applications.
• Proven extensive knowledge of EDI billing systems and third-party payor billing process management.
• Proven history of proactively identifying, resolving, and escalating issues that impact business outcomes.
• Possess complete understanding of the billing/collection process to resolve complex, outstanding claims.
• Excellent critical thinking, organizational and time management skills with a strong attention to detail, accuracy and follow through.
• Demonstrated strong and persuasive verbal, written and interpersonal communication skills.
• Proven track record showing good decision-making skills based upon a mixture of analysis, experience, and judgment.
• In-Depth knowledge of Microsoft Office (Teams, Outlook, Excel etc)
• Basic Data Analytic Skills (Power Query, Pivot Tables etc)
• Proven ability to work collaboratively in a team environment in a positive and professional manner.

Environmental Job Requirements and Working Conditions

• Our organization follows a hybrid schedule, with in-office work on Tuesdays, Wednesdays, and Thursdays, and remote work on other days. This schedule may be subject to change based on business needs. 
• The office is located at 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801.
• The total compensation target pay rate for this role is: $20.00 - $25.00/hr. The pay range represents our national target range for this role.