Medical Biller w/ California Insurance Experience (Bilingual Spanish - English)
RemoteCalifornia, United States
Job Summary
Manage the full-cycle medical billing process from claim creation to final payment resolution, including accurate claim submission using ICD-10 and CPT coding. Handle payment posting, reconciliation, and adjustments while monitoring Accounts Receivable to ensure timely collections. Conduct denial management and follow-ups, including appeals and resubmissions, alongside insurance verification and eligibility checks. Process and manage prior authorizations for procedures and services by navigating payer portals for claims and follow-ups. Support front-office operations, including patient intake and insurance-related inquiries, while ensuring compliance with medical necessity documentation. Collaborate with providers and internal teams to resolve billing discrepancies. Requires 2+ years of end-to-end medical billing experience and extensive familiarity with California insurance systems, Medicare, and Medi-Cal.
Required Qualifications
- 2+ years of end-to-end medical billing experience
- Strong proficiency in claim submission and generation
- Strong proficiency in ICD-10 and CPT coding
- Strong proficiency in payment posting
- Strong proficiency in A/R management
- Strong proficiency in denial handling and follow-ups
- Extensive experience with insurance verification and prior authorizations
- Hands-on experience working with Medicare
- Hands-on experience working with Medicaid / Medi-Cal
- Hands-on experience working with Medicare Advantage plans
- Hands-on experience working with HMO plans in California
- Deep familiarity with U.S. insurance portals
- Strong understanding of medical necessity requirements
- Excellent communication and problem-solving skills
- Willingness to work in US time zones (PST, EST, CST)
Desired Qualifications
- High school diploma or equivalent
- Experience working with Independent Physician Associations (IPAs)
- Background in Primary Care and/or ENT (Ear, Nose, and Throat) specialties
- Experience with DrChrono EHR
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