We are seeking a detail-oriented Medical Billing Collections Specialist to join our team and ensure accurate and timely management of claims for Skilled Nursing Facility services. As a key contributor to the revenue cycle, you'll handle critical tasks such as claims submission, denials management, and appeals, while ensuring compliance with Medicare, Medi-Cal, and other insurance guidelines. Key Responsibilities: Claims Submission: Accurately and promptly prepare and submit claims to insurance payers for Skilled Nursing Facility services. Denials Management: Review denied claims, identify root causes, and implement corrective actions to minimize future denials. Appeals: Draft and submit effective appeals for claim denials to secure appropriate reimbursements. Billing Accuracy: Maintain detailed, accurate patient records, ensuring compliance with Medicare, Medi-Cal, and payer-specific requirements. Follow-Up: Communicate with insurance companies and other payers to resolve outstanding claims and secure timely reimbursements. Regulatory Compliance: Stay informed and ensure adherence to all federal, state, and local billing regulations, including compliance with HIPAA. Collaboration: Work closely with administrative and clinical teams to optimize billing workflows and integrate documentation processes. Reporting: Generate clear, actionable account reports showing billing trends, claim statuses, and resolution timelines for management review.

Medical Billing, Medical Collections, Medical Appeals, Medical Denials, Medicare Billing, Medicare, Medicare Advantage, Medi-Cal, Skilled Nursing, Skilled nursing facility (SNF)

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Duarte, CA
onsite
Contract / Temporary to Hire
25.12 - 31.23 USD / Hourly
We are seeking a detail-oriented Medical Billing Collections Specialist to join our team and ensure accurate and timely management of claims for Skilled Nursing Facility services. As a key contributor to the revenue cycle, you'll handle critical tasks such as claims submission, denials management, and appeals, while ensuring compliance with Medicare, Medi-Cal, and other insurance guidelines. Key Responsibilities: Claims Submission: Accurately and promptly prepare and submit claims to insurance payers for Skilled Nursing Facility services. Denials Management: Review denied claims, identify root causes, and implement corrective actions to minimize future denials. Appeals: Draft and submit effective appeals for claim denials to secure appropriate reimbursements. Billing Accuracy: Maintain detailed, accurate patient records, ensuring compliance with Medicare, Medi-Cal, and payer-specific requirements. Follow-Up: Communicate with insurance companies and other payers to resolve outstanding claims and secure timely reimbursements. Regulatory Compliance: Stay informed and ensure adherence to all federal, state, and local billing regulations, including compliance with HIPAA. Collaboration: Work closely with administrative and clinical teams to optimize billing workflows and integrate documentation processes. Reporting: Generate clear, actionable account reports showing billing trends, claim statuses, and resolution timelines for management review.
2025-10-20T17:57:31Z