Medical Billing and Insurance Specialist

We are seeking a Medical Billing & Insurance Specialist with advanced knowledge in facility claims follow-up, high-dollar claim denials, and appeals preparation. This role involves researching insurance claim issues, resolving denials, and ensuring accurate reimbursement for healthcare services.

The position offers a full-time hybrid schedule-4 days remote, 1 day in-office.

• Perform insurance claim follow-up for high-dollar facility claims.
• Investigate and resolve claim denials, including Medicare Exhaust, Coordination of Benefits (COB) conflicts, and Recovery Audits.
• Prepare and submit appeals to insurance providers to secure payment.
• Analyze payer trends, document issues, and take corrective action.
• Process and complete the daily billing of paper claims and communicate with the billing team as needed.
• Maintain performance benchmarks for claims resolution and follow-up.
• Ensure compliance with insurance verification, pre-certification guidelines, and contractual billing specifications.

• High School Diploma or GED required (Associate's degree in healthcare, finance, or related field preferred).
• 1-2 years' experience in hospital-based patient accounting, billing, claims processing, or medical collections.
• Knowledge of Medicare, Medicaid, and commercial insurance claim processes.
• Strong analytical and problem-solving skills for complex insurance billing issues.

• Full-time, Hybrid: 4 days remote, 1 day in-office.
• On-site training for up to 90 days before transitioning to hybrid work.
• Pay: 25/hr - 29/hr

This role is ideal for individuals with strong experience in medical billing, claims follow-up, and appeals processing who are looking for a flexible, hybrid opportunity in the healthcare industry. Apply today to join a dynamic team dedicated to resolving complex insurance claims and ensuring proper reimbursement!

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.