US Medical billing / coder agent

Note : US medical billing experience must

Job Summary:

Medical Biller will work clinical team to bill for medical services. The medical biller will establish and maintain a tracking and submission system for medical claims. In addition, the medical biller will occasionally perform routine clerical and administrative functions such as drafting correspondence, organizing and maintaining paper and electronic files.

Job Duties & Responsibilities:

• Submit treatment authorization requests (TARs) to Medi-Cal
• Submit Medi-Cal claims, including claims for CalAIM covered services
• Follow up on the status of TARs and claims submitted
• Track eligibility for Medi-Cal and program services
• Submit authorizations and claims to managed Medi-Cal plans
• Submit billing data to the appropriate insurance providers
• Process claims
• Resolve denial instances
• Appeal denied authorizations and claims
• Achieve maximum reimbursement for services provided
• Establish and maintain tracking systems for billing submission
• Conduct audits and Medi-Cal reviews
• Assist with organizational readiness for contracting with larger partners (Alameda County, Alameda Alliance and Kaiser). This will include providing support for financial audits, compliance submissions, and billing reports
• Other duties as assigned

Minimum Required Skills & Qualifications:

• Medical biller experience: Minimum 1 year experience
• Comprehensive knowledge of medical terms and codes used in healthcare billing
• Ability to communicate in a clear and professional manner with patients, healthcare providers, and insurance companies regarding billing inquiries and outstanding balances
• Strong attention to detail with excellent organizational skills
• Strong critical thinking abilities
• Ability to manage multiple tasks efficiently and maintain organized records
• Proficiency with billing using Excel.
• Proficiency using Microsoft office: Word, Excel, Teams
• Familiarity with electronic health records (EHR) and medical billing software to submit claims electronically or manually if needed.
• Self-directed and able to work with minimal supervision

Preferred Skills & Qualifications:

• Medical biller experience: 2 years preferred
• College degree or specific certification related to position

Salary : 5 L to 12 L ( Annually, depends on experience and performance )