Medi-Cal Billing Specialist

Immediate need for a talented Medi-Cal Billing Specialist. This is a 03+ months contract opportunity with long-term potential and is located in Pomona, CA(Onsite). Please review the job description below and contact me ASAP if you are interested.

Job ID: 26-26626

Pay Range: $21 - $24/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• Review hospital accounts receivable aging reports and prioritize collection efforts
• Follow up with insurance carriers to collect outstanding balances and resolve claim issues
• Perform timely follow-up on institutional claims (UB-04)
• Investigate denied, rejected, or underpaid claims and submit appeals when appropriate to maximize reimbursement
• Identify and resolve payment variances and account discrepancies
• Obtain and verify patient insurance eligibility through insurance websites, payer portals, and customer service representatives
• Coordinate with billing and other internal departments to resolve claim and account discrepancies
• Document all collection and follow-up activities accurately in the hospital's billing system
• Maintain accurate account records and follow established billing and collection procedures
• Ensure compliance with HIPAA, hospital policies, and applicable state and federal regulations
• Communicate professionally and effectively with insurance carriers, internal departments, and other stakeholders

Key Requirements and Technology Experience: 

• Must have skills: 1-3 years of experience in hospital accounts receivable, medical billing, or healthcare collections
• Experience following up on institutional claims (UB-04)
• Understanding of CPT/ICD codes and DRG reimbursement
• 1-3 years of experience in hospital accounts receivable, medical billing, or healthcare collections
• Experience following up on institutional claims (UB-04)
• Experience working with insurance companies and payer portals
• Knowledge of hospital billing and accounts receivable processes
• Understanding of CPT/ICD codes and DRG reimbursement
• Familiarity with payer guidelines, including Medi-Cal, Medicare, and commercial payers
• Strong communication skills for interacting with insurance carriers and payer representatives
• Proficiency with hospital billing systems and Microsoft Office
• Strong attention to detail and analytical skills
• Ability to investigate claim denials, underpayments, and payment variances
• Knowledge of insurance eligibility verification through payer websites, portals, and customer service
• High School Diploma or GED

Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

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