<p>The Medical Biller & Collections Specialist is responsible for managing the full revenue cycle process to ensure timely and accurate reimbursement for services rendered. This role supports the financial health of the organization by overseeing insurance billing, payment posting, and patient account follow-up while maintaining strict compliance with healthcare regulations.</p><p><br></p><p>The specialist prepares, submits, and monitors insurance claims to commercial payers, Medicaid, and other applicable programs, ensuring claims are accurate, complete, and compliant with payer requirements. They research and resolve denied or underpaid claims, submit appeals when necessary, and communicate effectively with insurance companies to secure proper reimbursement.</p><p><br></p><p><strong>Key Responsibilities</strong></p><ul><li>Submit, review, and track medical claims for timely reimbursement</li><li>Post insurance and patient payments accurately</li><li>Investigate and resolve claim denials, rejections, and underpayments</li><li>Submit appeals and supporting documentation as required</li><li>Manage patient balances, collections, and payment plans</li><li>Communicate with insurance carriers and patients regarding billing inquiries</li><li>Maintain accurate billing records and documentation</li><li>Ensure compliance with HIPAA and payer guidelines</li></ul>
<p>A Hospital in Los Angeles is in the need of a Medical Billing Support Services Associate to join its healthcare team in Los Angeles. In this role, the Medical Billing Support Services Associate will play a crucial part in ensuring the accurate processing of cash receipts, managing patient eligibility reviews, and resolving recoupment statuses. The Medical Billing Support Services Associate must have strong background in medical billing and a commitment to excellence.</p><p><br></p><p>Responsibilities:</p><p>• Process cash receipts from both automated and manual payers, ensuring compliance with established procedures.</p><p>• Research and analyze unposted or unapplied cash to facilitate timely resolution and posting.</p><p>• Investigate unapplied cash receipts and escalate issues to supervisors when necessary.</p><p>• Reverse balances and adjust credits or debits to correct billing errors and payment applications.</p><p>• Review correspondence related to refunds or recoupments, taking appropriate actions such as issuing refund requests or submitting disputes.</p><p>• Evaluate credit balances and issue refunds to payers in an accurate and timely manner.</p><p>• Collaborate with Finance and other Revenue Cycle departments to streamline cash posting, balancing, and reconciliation processes.</p><p>• Address issues related to payment postings or refunds and communicate updates to management.</p><p>• Cross-train in billing processes, including charge entry, insurance eligibility verification, and resolving billing edits.</p><p>• Assist with special projects assigned by leadership, such as audits, payer compliance reviews, and case-specific billing and collections.</p>
The Medical Billing Support Services Associate I coordinate and performs all aspects of the processing of cash receipts from automated and manual payers in accordance with training materials, scripts, and standard operating procedures. Position also performs a variety of duties which may include reviewing overpayments, credits and recoupments. Making phone calls and/or using payers web portals to check patient eligibility or confirming status of pending recoupments. This role is a Hybrid Remote role. Candidate must live with in Los Angeles County. <br>Essential Duties:<br>• Understand the practice billing and collection system and process requirements for the automated and manual cash posting, batch balancing and reconciliation of cash receipts in the insurance billing process.<br>• Researches and analyzes un-posted cash on hand and unapplied cash to ensure timely posting and resolution.<br>• Investigate unapplied cash receipts and resolve or escalate in a timely manner to lead or supervisor.<br>• Reverses balance to credit or debit if charges were improperly billed.<br>• Contacts insurance carriers as necessary to determine correct payment application.<br>• Reviews correspondences related to refunds and or recoupments. Takes the necessary actions such as issuing a refund request or sending a dispute/appeal to the payer.<br>• Responsible for evaluating credit balances and ensuring that refunds are issued to the appropriate payer in a timely and accurate manner.<br>• Work with Finance and other Revenue Cycle Departments to optimize the cash posting, balancing and reconciliation process.<br>• Communicates issues related to payment posting and refunds from payers to management.<br>• Updates correct payer and resubmits claims to the payers.<br>• Consistently meets/exceeds productivity and quality standards.<br>• Cross trained and performs billing processes such as charge entry, insurance verification of eligibility and ensuring correct payer is billed, reviewing, and resolving billing edits from worklists.<br>• Cross trained and performs customer service duties as such as answering patient phone calls, patient email inquiries or division email inquiries related to patient balances.<br>• Contacting insurance payers on behalf of the patient and or with the patient on the call to resolve patient responsibility concerns. Review and resolve self-pay credit balances.<br>• Special projects assigned by leadership for example annual audits, escheatment reviews, payer projects, compliance monthly audits.<br>• Special billing and collections for LOAs.<br>• Special billing and collections for Case Rates.<br>• Special billing and collections for Embassy Services.<br>• Performs other related duties as assigned by management team.
<p>A Behavioral Healthcare Company is looking for an experienced Medical Billing Specialist with ABA experience to join its Revenue Cycle Team. The Medical Billing Specialist will play a vital role in managing the revenue cycle by ensuring accurate billing, payment processing, and authorizations. This Medical Billing Specialist requires someone with strong attention to detail who can navigate insurance claims, resolve discrepancies, assist patients with EOB explanation and maintain compliance with healthcare regulations.</p><p><br></p><p>Responsibilities:</p><p>• Prepare and submit medical claims to insurance companies, including commercial payers and private, ensuring accuracy and compliance.</p><p>• Monitor and track the status of submitted claims to ensure timely reimbursement.</p><p>• Post payments from insurance companies and patients with precision and accuracy.</p><p>• Manage patient account balances, including collections and establishing payment plans when necessary.</p><p>• Investigate and address claim denials, rejections, and underpayments, identifying solutions to secure proper reimbursement.</p><p>• Draft and submit appeals with supporting documentation to resolve complex claim issues.</p><p>• Communicate effectively with insurance carriers and patients to address billing inquiries and concerns.</p><p>• Maintain detailed and accurate records of billing activities and ensure compliance with payer guidelines.</p><p>• Support the organization’s financial health by optimizing the revenue cycle processes.</p><p>• ABA and/or Mental/Behavioral Health is a PLUS!</p><p><br></p><p>This company offer Medical, Dental and Vision Insurance. 401K Retirement Plan, Sick Time Off and Tuition reimbursement. </p>
<p>Robert Half is looking for a skilled Liability Claims Coordinator to join our client in Santa Ana, California. In this long-term contract position, you will play a vital role in managing liability claims, ensuring accurate documentation, and providing essential administrative support. This position is fully on-site with a unique schedule of 6am-3pm. </p><p><br></p><p>Responsibilities:</p><p>• Manage liability claims efficiently, ensuring proper documentation and timely processing.</p><p>• Perform detailed data entry to maintain accurate records and track case progress.</p><p>• Collaborate with internal teams to support auto defense and workers compensation claims.</p><p>• Conduct intake calls and gather information from clients.</p><p>• Monitor claim statuses and follow up as needed to ensure resolution.</p><p>• Analyze claims data to identify trends and improve processes.</p><p>• Maintain compliance with legal and organizational standards throughout the claims process.</p>
<p>A Behavioral Health Company in Long Beach is in the need of a Lead ABA Medical Biller with DMH experience. The Lead ABA Medical Biller will oversee the daily operations of the billing department and ensure compliance with mental health contract requirements. The Lead ABA Medical Biller must have behavioral health experience.</p><p><br></p><p>Responsibilities:</p><p>• Supervise and provide daily guidance to billing staff, ensuring adherence to established procedures.</p><p>• Conduct training, coaching, and performance evaluations for team members, supporting their growth and attention to detail.</p><p>• Review billing documentation and workflows to ensure accuracy and compliance with established protocols.</p><p>• Address claim denials by analyzing monthly revenue reports and implementing corrective measures.</p><p>• Collaborate with Quality Assurance staff to update administrative sections of client files as needed.</p><p>• Process electronic billing efficiently, ensuring clean and accurate claims using available technology.</p><p>• Reconcile billing reports for the Department of Mental Health and Behavioral Health Services, ensuring compliance with agency standards.</p><p>• Partner with the Billing Director to implement new procedures and provide operational feedback.</p><p>• Organize and facilitate departmental meetings and training sessions to improve team performance.</p><p>• Attend required meetings and training sessions to stay updated on internal and external systems relevant to billing operations.</p>
<p>A personal injury law firm is looking for a dedicated Case Manager to join their team for an estimate of 1 month on a contract basis in West Los Angeles. This role involves managing case-related tasks with a focus on ordering medical records and providing administrative support.</p><p><br></p><p><strong>Responsibilities</strong>:</p><p>• Coordinate and manage the process of ordering medical records for legal cases.</p><p>• Provide comprehensive administrative support to ensure the efficient handling of case-related matters.</p><p>• Organize and maintain accurate records, including electronic filing of legal documents.</p><p>• Assist in abstracting medical records and compiling relevant data for case analysis.</p><p>• Collaborate with legal professionals to ensure cases are prepared and managed effectively.</p>
We are looking for a skilled Case Manager to join our team in Encino, California. In this role, you will oversee multiple pre-litigation cases, ensuring prompt and effective resolution while providing exceptional support to clients. This is an onsite position that offers a dynamic work environment and opportunities for growth.<br><br>Responsibilities:<br>• Manage multiple pre-litigation cases, ensuring timely and effective resolution.<br>• Supervise and guide entry-level case managers in their daily tasks and responsibilities.<br>• Facilitate claims processing with insurance carriers, including health insurance, Medicare, and Medi-Cal.<br>• Coordinate property damage and loss of use claims, ensuring proper resolution.<br>• Identify healthcare providers and schedule medical appointments for injury treatment.<br>• Advocate for clients by monitoring their medical treatment and arranging necessary care based on provider recommendations.<br>• Review, analyze, and interpret medical records, surgical reports, and medical bills.<br>• Prepare case files and documentation for submission to the demands department.<br>• Communicate effectively with clients, healthcare providers, and internal staff to maintain a high level of service.
<p>A Behavioral Health Company in Long Beach is in the need of a Lead Medical Billing Operations Coordinator. The Lead Medical Billing Operations Coordinator will oversee the daily operations of the billing department and ensure compliance with mental health contract requirements. The Lead Medical Billing Operations Coordinator must have behavioral health experience. </p><p><br></p><p>Responsibilities:</p><p>• Supervise and provide daily guidance to billing staff, ensuring adherence to established procedures.</p><p>• Conduct training, coaching, and performance evaluations for team members, supporting their growth and attention to detail.</p><p>• Review billing documentation and workflows to ensure accuracy and compliance with established protocols.</p><p>• Address claim denials by analyzing monthly revenue reports and implementing corrective measures.</p><p>• Collaborate with Quality Assurance staff to update administrative sections of client files as needed.</p><p>• Process electronic billing efficiently, ensuring clean and accurate claims using available technology.</p><p>• Reconcile billing reports for the Department of Mental Health and Behavioral Health Services, ensuring compliance with agency standards.</p><p>• Partner with the Billing Director to implement new procedures and provide operational feedback.</p><p>• Organize and facilitate departmental meetings and training sessions to improve team performance.</p><p>• Attend required meetings and training sessions to stay updated on internal and external systems relevant to billing operations.</p>
