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Medical Billing A/R Specialist

Eye Medical Center of Fresno, Inc.
Fresno, CA Full Time
POSTED ON 3/18/2025
AVAILABLE BEFORE 5/17/2025

Position: Medical Billing Specialist

Primary Duties:

With precision and accuracy, prepare and submit each claim. Ensuring each goes out clean, with up-to-date medical information and billing codes, to guarantee accurate payment at first submission. As necessary, perform any follow up tasks required in pursuit of proper payment.

  • Meet daily, monthly and quarterly collection goals set by billing supervisor.
  • Process number of accounts per day as assigned.
  • Analyze EOBs and construct response to insurance carriers based on claim adjudication.
  • Manage AR of assigned accounts including processing insurance denials and or appeals, which may include phone contact with insurance companies.
  • Follow up with payers and other appropriate parties to collect open balances in a timely manner, ensuring compliance with payer guidelines.
  • Initiate refund requests for supervisor’s approval.
  • Identify and report payer issues with regard to rejection trends, denial trends, or change in payments. Communicate specific payer information to appropriate parties and or departments.
  • Identify and address denial and or zero payments and correct billing submissions.
  • Follow up and complete tasks on pending accounts in a timely manner and until account is settled.
  • Other job duties as assigned.

Other Job Criteria:

  • Exhibit high levels of customer service and communication skill, verbal and writing, in all interactions both internally and with outside companies.
  • Ability to proficiently utilize all company technology to perform job duties (e.g., answer phones, send emails, and updating patient accounts as needed).
  • Blend education, skills and experience on an ongoing basis.
  • Ability to work in a team setting and independently with minimal supervision, alternating between each as circumstances require.
  • Advanced time management skills, efficiently complete job duties with extreme accuracy.
  • Advanced organization skills, using professional judgment to prioritize high volume workload.
  • Maintain patient and job confidentiality, ensuring compliance with HIPAA standards.
  • Appearance and habits do come to work with presentable personal hygiene and attire.
  • Reliable, dependable, and able to maintain job attendance with minimal absence.
  • Perform job duties in spite of unforeseen obstacles, with versatility and positive personal temperament under stress and or pressure.
  • Sitting and for long periods of time.

Education/Experience:

  • High School Diploma or GED
  • Two or more years of experience in medical accounts receivable (AR), claims billing, appeals, processing denials, and submitting electronic data interchange (EDI) claims.
  • Extensive experience and proficiency in date entry.
  • Proficiency in explanation of benefits (EOB) analysis, payment adjustments, and medical terminology.
  • Proficiency in understanding of CPT and HCPCS codes, AR follow-up, and payment reconciliation, and all revenue cycle functions and interrelationships.
  • Medi-Cal billing experience required.

Job Type: Full-time

Pay: $39,520.00 - $52,000.00 per year

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Employee assistance program
  • Employee discount
  • Flexible spending account
  • Health insurance
  • Life insurance
  • Paid time off

Schedule:

  • Monday to Friday

Work Location: In person

Salary : $39,520 - $52,000

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