<p>A boutique <strong>family medicine and wellness practice</strong> in <strong>Rancho Santa Fe</strong> is looking for a reliable and detail-oriented <strong>Medical Biller</strong> to join their administrative team. This role will handle end-to-end billing functions including claim submission, payment posting, and patient collections for a small but high-volume private office.</p><p>The ideal candidate will be self-sufficient, organized, and knowledgeable in both insurance and private-pay billing processes.</p><p><br></p><p><strong>Key Responsibilities:</strong></p><ul><li>Accurately process and submit insurance claims through clearinghouses and payer portals.</li><li>Verify patient eligibility and benefits prior to appointments.</li><li>Post insurance and patient payments; reconcile deposit logs.</li><li>Manage denials, rejections, and appeals with appropriate documentation.</li><li>Generate patient statements and follow up on outstanding balances.</li><li>Maintain compliance with HIPAA and practice policies.</li><li>Communicate with patients regarding billing inquiries in a professional manner.</li><li>Coordinate with the front office and clinical staff to resolve coding or authorization discrepancies.</li><li>Maintain accurate digital and paper billing files.</li></ul>
<p>Are you an experienced Medical Biller/Collector with strong leadership skills and a passion for solving complex billing issues? Join a dynamic team as our next <strong>Lead Medical Biller Collector</strong>! We are seeking a driven professional with hands-on experience in medical billing and collections, appeals, denials management, and overseeing a high-performing team.</p><p><strong>Key Responsibilities:</strong></p><ul><li>Lead and assist in overseeing a team of medical billers and collectors, providing mentorship and ensuring optimal team performance.</li><li>Actively contribute to the day-to-day production of billing and collections processes.</li><li>Manage and resolve all aspects of insurance denials, including appeals and root-cause analysis.</li><li>Collaborate with team members to create strategies that minimize denials and optimize operational workflows.</li><li>Work with Medi-Cal, Medicare, and Commercial medical insurance payers to ensure timely and accurate claim submissions and payments.</li><li>Stay informed of changes in insurance guidelines and compliance requirements</li></ul><p><strong>Qualifications:</strong></p><ul><li>Proven experience in a medical billing and collections role, including leading or assisting in managing a team.</li><li>Hands-on expertise in insurance appeals, denials management, and identifying root causes of claim denials.</li><li>In-depth experience working with Medi-Cal, Medicare, and Commercial insurance providers.</li><li>Strong knowledge of medical billing systems and coding practices (CPT, ICD-10, HCPCS).</li><li>Excellent problem-solving, organizational, and communication skills.</li><li>Ability to work both independently and collaboratively in a remote environment.</li></ul><p><br></p><p><br></p>
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.<br><br>Key Responsibilities:<br><br>Claims Submission: Accurately and promptly prepare and submit claims to insurance payers for Skilled Nursing Facility services.<br>Denials Management: Review denied claims, identify root causes, and implement corrective actions to minimize future denials.<br>Appeals: Draft and submit effective appeals for claim denials to secure appropriate reimbursements.<br>Billing Accuracy: Maintain detailed, accurate patient records, ensuring compliance with Medicare, Medi-Cal, and payer-specific requirements.<br>Follow-Up: Communicate with insurance companies and other payers to resolve outstanding claims and secure timely reimbursements.<br>Regulatory Compliance: Stay informed and ensure adherence to all federal, state, and local billing regulations, including compliance with HIPAA.<br>Collaboration: Work closely with administrative and clinical teams to optimize billing workflows and integrate documentation processes.<br>Reporting: Generate clear, actionable account reports showing billing trends, claim statuses, and resolution timelines for management review.
<p>A Surgery Center in Los Angeles is in the need of a Surgery Medical Billing Collections Specialist. The Surgery Medical Billing Collections Specialist must have at least 2 years of experience in the healthcare industry. The Surgery Medical Billing Collections Specialist must be able to work review aged EOBs and resolve denials.</p><p>DUTIES AND RESPONSIBILITIES</p><p>-Performs full cycle billing and collection functions for OHMG Surgical detail-oriented fees.</p><p> -Verify patient eligibility, authorization status and primary payer information via CareConnect and Insurance portals prior to claim submission.</p><p> -Performs all data entry and charge posting functions for OHMG services as needed -Performs all third-party follow-up functions for all products and OHMG surgical procedures.</p><p> -Reviews EOBS and Denials. Make corrections as required and resubmit the claim for payments.</p><p> -Work on the Athena Work Dashboard / Claim list on a daily basis for all services assigned.</p><p> -Performs daily review of Urgent Care provider chart notes to assure that documentation is complete and supportive of submitted charges prior to billing.</p><p>-Provides the correct ICD-10M code to identify the provider's narrative diagnosis -Provides the correct HCPCS code to identify medications and supplies.</p><p> -Provides the correct CPT code to accurately identify the services performed based on the provider's documentation.</p><p>- Reviews all surgical operative reports and assigns appropriate CPT codes and ICD-10-CM codes for services performed by staff surgeons.</p>
