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Medical Billing and Collections Representative

California Advanced Pain and Spine Specialty
Fresno, CA Full Time
POSTED ON 2/5/2025
AVAILABLE BEFORE 4/4/2025

Job Summary
We are seeking a detail-oriented and knowledgeable Medical Billing and Collections Representative to join our team. The ideal candidate will be responsible for facilitating and utilizing the best strategies for the optimization of revenue, billing, and collections process. Responsibilities include the utilization of claims worklist and HUB to maintain timely resubmission of held or denied claims and timely follow up. Position will be accountable for researching coding, billing, and change compliance. Recommendation of corrective action, escalation of problematic claims with payers as needed. Duties require working a daily average of 24 claims per day. Providing support to front office staff regarding billing issues, data entry and improvement opportunities. Adherence to all applicable confidentiality laws and requirements, company policies and procedures, Federal and State regulations, and laws. Duties and assignments may vary as determined by the Practice Administrator and/or billing and /or patient care issues.

Qualifications

  • Medical Billing & Terminology Certification
  • Two-year college degree is preferred

Required Knowledge, Experience and Skills

  • Intermediate knowledge of ICD9/10 and CPT coding, insurance terminology and billing software
  • Basic mathematical calculations to balance and reconcile transactions
  • 4 plus recent years' experience in submitting corrected, additional information, disputed and appealed medical claims
  • Maintain confidentiality of patient care and business information
  • Working knowledge of computers, office equipment, MS 365, proficient use of email systems
  • COB resolution
  • Strong negotiation skills
  • Current NCCI edits knowledge
  • Experience with clearing house claims corrections and resubmissions
  • Familiarity with Medicare, PPO, HMO, WC, and TPA payer billing guidelines
  • Familiarity with billing secondary and tertiary payors
  • Self-motivated and have the ability to prioritize work and meet deadlines

Employer offers a generous benefits package including employer paid health coverage, dental and vision coverage, Flexible and Dependent Care Spending Accounts, Employee Assistance Program, retirement plan, 10 paid annual holidays, PTO, PSL and a paid Personal Day to be utilized on the employee's birthday. If you have expertise in the areas listed and feel that you would be a great addition to our company, we encourage you to apply.

Job Type: Full-time

Pay: $22.00 - $25.00 per hour

Expected hours: 40 per week

Benefits:

  • 401(k)
  • Dental insurance
  • Employee assistance program
  • Flexible spending account
  • Health insurance
  • Life insurance
  • Paid time off
  • Parental leave
  • Professional development assistance
  • Retirement plan
  • Vision insurance

Schedule:

  • 8 hour shift
  • No weekends

Work Location: In person

Salary : $22 - $25

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