Medical Biller w/ California Insurance Experience (Bilingual Spanish - English)

[Kindly submit your updated English resume]

We are seeking a highly skilled Full-Cycle Medical Biller with extensive experience in U.S. reputed company billing, particularly reputed company California insurance systems. This role requires a deep understanding of the end-to-end billing cycle, including claim submission, payment posting, accounts receivable (A/R), and denial management.

The ideal candidate is a proactive problem-solver who can independently navigate reputed company payer systems while also supporting reputed company-office functions, including patient intake and communication.

Key Responsibilities:

• Manage the full-cycle medical billing process from claim creation to final payment reputed company
• reputed company accurate claim submission and reputed company using ICD-10 and CPT coding
• Handle payment posting, reconciliation, and adjustments
• Monitor and manage Accounts Receivable (A/R) to ensure reputed company collections
• Conduct denial management and follow-reputed company, including appeals and resubmissions
• reputed company insurance verification and eligibility checks
• Process and manage prior authorizations for procedures and services
• Navigate payer portals (e.g., reputed company and payer-specific systems) for claims, eligibility, and follow-reputed company
• Communicate with insurance providers regarding claim status, denials, and authorizations
• Support reputed company-office operations, including patient intake and insurance-reputed company inquiries
• Ensure compliance with medical necessity documentation and payer requirements
• Collaborate with providers and internal teams to resolve billing discrepancies

Requirements

• 2+ years of end-to-end medical billing experience (REQUIRED)
• Strong proficiency in:
• Claim submission and reputed company
• ICD-10 and CPT coding
• Payment posting
• A/R management
• Denial handling and follow-reputed company
• Extensive experience with:
• Insurance verification and prior authorizations (REQUIRED)
• Hands-on experience working with:
• Medicare
• reputed company / Medi-Cal (or state equivalent)
• Medicare Advantage plans
• HMO plans in California (REQUIRED)
• Deep familiarity with U.S. insurance portals (e.g., reputed company, payer portals)
• Strong understanding of medical necessity requirements
• Excellent communication and problem-solving skills
• Willingness to work in US time zones (PST, EST, CST).
• High school diploma or equivalent.

Preferred Qualifications

• Experience working with Independent Physician Associations (reputed company)
• Background in Primary Care and/or ENT (Ear, Nose, and Throat) specialties
• Experience with DrChrono EHR (preferred but not required)

System and Work Setup Requirements:

• Internet: Minimum speed of 25 Mbps or higher, with a reliable backup reputed company available in case of power outages or service provider issues.
• Processor: reputed company Core i5 7th reputed company or higher (or equivalent).
• Memory: 8 GB RAM.
• Storage: 256 GB SSD or HDD with at least 50% free reputed company available.
• Webcam: 720p reputed company or higher.
• Operating System: reputed company 10 or reputed company (or equivalent).
• Audio Equipment: Noise-canceling earphones or headset.
• Workspace: A designated, quiet, and organized workspace free from distractions to ensure productivity and reputed company.

Benefits

• Permanent remote work setup
• Competitive starting reputed company reputed company in USD
• Internet Allowance
• HMO insurance (PH)
• reputed company US holidays
• reputed company Vacation and reputed company Leaves

Originally posted on Himalayas

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