Billing Specialist

Las Vegas, NV - USA

Hourly Salary: $ 19 - 22

Posted on: 9 hours ago

Vacancies: 1 Vacancy

Job Summary

We are seeking a highly organized detail-oriented Billing Specialist to support accurate timely and compliant revenue cycle operations. This role plays a critical part in ensuring clean claim submission efficient denial resolution and optimal reimbursement across multiple payer lines of business.

The ideal candidate thrives in a fast-paced healthcare environment understands both front-end and back-end billing workflows and is committed to accuracy collaboration and continuous process improvement. Experience with value-based care and risk-adjusted payment models is strongly preferred.

This position directly supports our mission of improving patient outcomes while maintaining financial integrity within the healthcare system.

Our Values

Putting Patients First
Operating with Integrity & Excellence
Being Innovative
Working as One Team

What Youll Do

Front-End Billing

Review charges for completeness compliance and accuracy before claim submission.
Validate CPT HCPCS ICD-10 codes modifiers place of service and provider information.
Confirm payer sequencing insurance eligibility demographics and authorization requirements.
Create and submit clean claims in eCW using approved workflows.
Identify and correct missing or unsupported services prior to submission to prevent denials.

A/R Follow-Up & Denial Management

Perform comprehensive follow-up on outstanding claims by payer and aging bucket.
Investigate claim delays denials rejections coding issues and system errors.
Contact payers via portals and phone to resolve claim issues and document outcomes.
Submit corrected claims appeals and supporting documentation as needed.
Identify denial trends and communicate recurring barriers to leadership.
Support backlog clean-up initiatives and improvement in cash flow performance.

Documentation & Workflow Standards

Maintain clear complete documentation on 100% of touched claims including date/time action taken outcome representative/contact reference and next steps.
Follow eCW queue workflows and approved action/result codes.
Ensure claims do not remain inactive beyond three (3) business days.

Collaboration & Communication

Work closely with Coding Credentialing Payment Posting Clinic Leadership and RCM Management.
Escalate barriers promptly (payer issues missing documentation portal problems).
Assist with phone coverage and maintain excellent internal and external communication.
Maintain professionalism respect and a solution-focused approach in all interactions.

Compliance & Professional Standards

Maintain HIPAA compliance and protect PHI at all times.
Follow Astrana SOPs payer policies and revenue cycle workflows.
Uphold professionalism and courtesy in all interactions.

Qualifications

High school diploma or equivalent required; billing certification (CPB CMRS) or associate degree preferred.
Minimum 2 years of medical billing experience in a multi-specialty or primary care environment.
Strong understanding of CPT HCPCS ICD-10 coding fundamentals modifiers and payer-specific billing rules.
Experience with Medicare Advantage Medicaid Managed Care HMO/PPO plans.
Experience using EMR/PM systems (eCW preferred).
Knowledge of risk adjustment RAF/HCC coding relevance and value-based care models preferred.
Excellent organizational time management and communication skills.

Environmental Job Requirements and Working Conditions

This role begins with a minimum of 8 weeks fully onsite for training at our office located at 8880 W Sunset Rd Suite 320 Las Vegas NV 89148. After onboarding and demonstration of consistent performance employees may be considered for a hybrid schedule based on productivity and business needs.
Scheduling options: 7:30 AM 4:00 PM or 8:00 AM 4:30 PM with a 30-minute lunch between 12:001:00 PM.
The total compensation range for this role is $19$22/hour. Actual compensation will be determined based on geographic location (current or future) experience and other job-related factors.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race religion color national origin gender (including pregnancy childbirth or related medical conditions) sexual orientation gender identity gender expression age status as a protected veteran status as an individual with a disability or other applicable legally protected characteristics. All employment is decided on the basis of qualifications merit and business need. If you require assistance in applying for open positions due to a disability please email us at to request an accommodation.

Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

Required Experience: