JOB DESCRIPTION
Position: Medical Biller / Accounts Receivable (AR) Specialist
Pay Range: $27.00-$30.00 PER HR
Reporting To: Reimbursement Manager
Work Type: On-Site
POSITION SUMMARY:
The Medical Biller / AR Specialist Must have strong revenue cycle experience including hands on work with CalAIM (Medi Cal managed care). The Medical Biller/ AR Specialist will own end to end billing follow ups denials management and AR resolution to drive clean claims and steady cash flow.
REQUIRED QUALIFICATIONS:
- High school diploma or GED preferred.
- 3 years of medical billing/AR follow up experience in a healthcare setting.
- Proven proficiency with Medi Cal managed care and commercial payers claim workflows.
- Track record resolving denials submitting appeals and obtaining/correcting authorizations.
- Proficiency with EMR/EHR and billing systems; strong Excel skills (filters sorting lookups).
- Exceptional attention to detail organization and written communication.
PREFFERED QUALIFICATIONS:
- Direct CalAIM experience (e.g. ECM/CS or other CalAIM benefits) MCP portal submissions and authorization management.
- Home health or community-based services billing background.
ESSNENTIAL DUTIES AND RESPONSIBILITIES:
The following is a representation of the major duties and responsibilities of this position. The agency will make reasonable accommodations to allow otherwise qualified applicants with disabilities to perform essential functions.
- Prepare review and submit clean claims to Medi Cal commercial payers and managed care plans.
- CalAIM: submit and track claims to MCPs verify authorizations resolve denials tied to medical necessity prior auth referrals and program eligibility; prepare professional appeal letters and retro-auth requests when applicable.
- Perform accurate charge entry payment posting and adjustments; reconcile remittances (ERA/EOB) and maintain precise documentation in EMR/billing systems.
- Work AR aging by payer and by program); identify denial patterns and escalate root causes with clear summaries.
- Answer billing inquiries from patients providers and MCPs with professional timely communication.
PHYSICAL REQUIREMENTS:
- Stand sit talk hear reach stoop kneel and use of hands and fingers to operate computer telephone and keyboard on a frequent basis (up to 75% of the time).
- Close vision requirements due to computer work.
- Light to moderate lifting may be required (up to 25lbs).
Required Experience:
IC
JOB DESCRIPTION Position: Medical Biller / Accounts Receivable (AR) SpecialistPay Range: $27.00-$30.00 PER HRReporting To: Reimbursement ManagerWork Type: On-Site POSITION SUMMARY:The Medical Biller / AR Specialist Must have strong revenue cycle experience including hands on work with CalAIM (Med...
JOB DESCRIPTION
Position: Medical Biller / Accounts Receivable (AR) Specialist
Pay Range: $27.00-$30.00 PER HR
Reporting To: Reimbursement Manager
Work Type: On-Site
POSITION SUMMARY:
The Medical Biller / AR Specialist Must have strong revenue cycle experience including hands on work with CalAIM (Medi Cal managed care). The Medical Biller/ AR Specialist will own end to end billing follow ups denials management and AR resolution to drive clean claims and steady cash flow.
REQUIRED QUALIFICATIONS:
- High school diploma or GED preferred.
- 3 years of medical billing/AR follow up experience in a healthcare setting.
- Proven proficiency with Medi Cal managed care and commercial payers claim workflows.
- Track record resolving denials submitting appeals and obtaining/correcting authorizations.
- Proficiency with EMR/EHR and billing systems; strong Excel skills (filters sorting lookups).
- Exceptional attention to detail organization and written communication.
PREFFERED QUALIFICATIONS:
- Direct CalAIM experience (e.g. ECM/CS or other CalAIM benefits) MCP portal submissions and authorization management.
- Home health or community-based services billing background.
ESSNENTIAL DUTIES AND RESPONSIBILITIES:
The following is a representation of the major duties and responsibilities of this position. The agency will make reasonable accommodations to allow otherwise qualified applicants with disabilities to perform essential functions.
- Prepare review and submit clean claims to Medi Cal commercial payers and managed care plans.
- CalAIM: submit and track claims to MCPs verify authorizations resolve denials tied to medical necessity prior auth referrals and program eligibility; prepare professional appeal letters and retro-auth requests when applicable.
- Perform accurate charge entry payment posting and adjustments; reconcile remittances (ERA/EOB) and maintain precise documentation in EMR/billing systems.
- Work AR aging by payer and by program); identify denial patterns and escalate root causes with clear summaries.
- Answer billing inquiries from patients providers and MCPs with professional timely communication.
PHYSICAL REQUIREMENTS:
- Stand sit talk hear reach stoop kneel and use of hands and fingers to operate computer telephone and keyboard on a frequent basis (up to 75% of the time).
- Close vision requirements due to computer work.
- Light to moderate lifting may be required (up to 25lbs).
Required Experience:
IC
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