Medical Biller – Errors Processing

Yosemite Pathology (YP) is a private independent pathologist owned and operated surgical pathology and cytology laboratory based in Modesto CA. YP provides comprehensive state of the art reliable and accurate diagnostic services to its physicians and major area hospitals in the Alameda Amador Calaveras Contra Costa Kern Mariposa Merced San Joaquin Solano Stanislaus and Tuolumne counties.

YP offers a full spectrum of tissue pathology cytology and histology services including examination of gynecologic specimens body fluids and fine needle aspiration specimens. We also offer an extensive array of special stains and immunohistochemistry to assist in the management of oncologic and non-oncologic diseases. The laboratory is supported by highly qualified Histotechnologist Cytotechnologist Technicians and office staff who offer excellent service.

Summary/Objective

The Error Processing Specialist is responsible for supporting the revenue cycle through accurate and timely billing operations error resolution and account follow-up. This role focuses on ensuring clean claim submission maintaining data integrity and resolving issues that may delay reimbursement. Key focus areas include eligibility and insurance verification payor portal utilization front-end billing processes professional communication and effectively managing high-volume workloads. The ideal candidate is detail-oriented proactive and capable of working efficiently in a fast-paced environment while maintaining compliance with all regulatory requirements.

Shift: Monday - Friday 8:00 am - 5:00 pm

Essential Functions

• Answer and appropriately direct incoming phone calls
• Respond to emails promptly and professionally
• Maintain an organized and up-to-date work queue in alignment with manager-defined timeframes; consistently meet daily KPIs
• Update patient demographics and insurance information as needed
• Review and resolve daily Error Processing worklists (e.g. invalid addresses missing authorizations undetermined eligibility) in a timely manner
• Perform eligibility and insurance verification to ensure accurate billing and reimbursement
• Utilize payor portals to review claim status verify benefits and resolve issues
• Execute front-end billing processes ensuring clean and accurate claim submission
• Communicate effectively with clients patients and insurance carriers
• Demonstrate professional phone etiquette in all interactions
• Refer qualifying accounts to third-party collection agencies as appropriate
• Maintain strict adherence to HIPAA regulations including when accessing client portals
• Proactively identify clearinghouse rejection trends and escalate findings to management
• Effectively manage a high-volume workload while maintaining accuracy and productivity standards
• Perform additional duties as assigned

Job Requirements and Skills

• Minimum of 3 years of medical billing experience (pathology billing experience preferred)
• High school diploma or equivalent required
• Advanced knowledge of PPO HMO IPA CMS Managed Medicaid and Managed Medicare plans
• Working knowledge of CPT and ICD coding
• Strong understanding of insurance eligibility and benefits verification
• Proficiency in payor portal utilization and navigation
• Knowledge of front-end billing processes and workflows
• Demonstrated professional phone etiquette
• Proven ability to manage high-volume workloads efficiently while maintaining accuracy
• Detail-oriented with a proactive positive approach to problem-solving
• Ability to collaborate effectively in a team environment
• Strong organizational skills with the ability to manage multiple priorities and adapt to changing demands
• Excellent written and verbal communication skills
• Strong documentation research and issue resolution capabilities
• Ability to multitask in a fast-paced high-volume results-driven environment
• Proficiency in reading and interpreting Explanation of Benefits (EOBs)
• Proficient in Microsoft Office Suite with advanced skills in Excel and Word

Work Environment & Expectations

• Fast-paced high-volume billing environment
• Regular use of computers billing systems and payor portals
• Frequent communication with internal teams patients and external partners
• Adherence to productivity quality and compliance standards

Compensation and Benefits

• The compensation range is $43680 - $ 52000 annually (non-exempt) paid semi-monthly on an eight (8) hour per day forty (40) hour per week. Final salary offer subject to multiple factors including candidate experience and expertise geographic location of the role and current market data.
• 401(k) includes an employer match up to 4%
• Robust health plans including dental vision life and mental health support.
• Offer generous annual vacation and sick time
• 10 paid holidays
• Annual scrub allowance for Lab roles

All offers of employment at Yosemite Pathology are contingent upon clear results of a thorough background check. Background checks will be conducted on all final candidates.