Medical Biller, Physician Claims 25-00346

Position: Billing Associate - Physician Charges 
Hybrid Role: In Office (1) day weekly. 
Assignment Length: Contract/Possible Contract to Hire 

Summary
The Billing Associate I position is responsible for assuring the timely submission/resubmission of a clean and accurate claim (electronic & paper), which includes reviewing all claim information and attaching supporting documentation as required by payer prior to bill submission.  

Duties
Paper Claims

• Review charge tickets for completeness based on division and payer requirements
• Validate: Insurance verification, eligibility, diagnosis codes, procedure codes, and required billing documentation
• Enter charges per division guidelines using provided documentation, including SharePoint workflow items
• Maintain billing logs for reconciliation between divisions and revenue cycle

Electronic Claims

• Work billing edits related to insurance verification, eligibility, diagnosis codes, procedure codes, and payer-required fields

Additional Responsibilities

• Accurately post and void adjustments as needed
• Request supporting documentation from clinics, patients, or insurance companies
• Resubmit claims with updated or corrected information per payer guidelines
• Refer claims to appropriate Revenue Cycle team for required updates or corrections
• Document actions taken or needed for claim submission
• Escalate problematic claims with recommendations to team lead or designated billing personnel
• Assist with special projects as assigned
• Maintain up-to-date knowledge of billing guidelines
• Meet established productivity and quality standards consistently

Qualiications 

1. At least two (2) years physician billing experience required. 
2. Physician Medi-Cal billing experience required. 
3. CCS (California Children's Services) billing experience preferred. 
4. Ability to communicate effectively in both written and verbal formats with internal and external customers.
5. Ability to handle multiple tasks simultaneously.
6. Familiarity with payer billing and reimbursement guidelines & regulations, including the ability to read and interpret payer Explanation of Benefits (EOB) and Remittance Advice Details (RAD).
7. Working knowledge of ICD-10.
8. Ability to organize and manage time effectively.
9. Handle, in a professional and confidential manner, all correspondence, documentation, and files following HIPAA & PHI guidelines.

INDH