Medical Billing & Denial Specialist

Titanium Healthcare•Garden Grove, CA

5d•Hybrid

About The Position

Titanium Healthcare is seeking a motivated Medical Billing & Denial Specialist to join our growing and dynamic team. This individual will be responsible for the posting, evaluating, and billing of claims and outstanding accounts receivable within the EHR (electronic health records) system. This includes evaluating EHR data integrity as it relates to account receivable, performing data entry, reporting, and billing tasks. In addition, the billing specialist will be responsible for ensuring that information is processed accurately, payments are posted, and denials are resubmitted in a timely fashion. This individual will work in collaboration with the revenue cycle, finance, and data team.

Requirements

Able to understand and become proficient in medical billing software
Familiarity with Medi-Cal, Medicare, commercial, and patient billing
Must have initiative, rely on experience, and sound judgement in making decisions in varied situations
Familiar with the utilization of an EHR (electronic health record) system
Ability to multi-task, prioritize, and see projects through to completion
Be able to work independently and is self-directed
Experience with primary care and Medi-Cal billing
Strong organizational and time management skills with attention to detail
Occasionally required to move or carry training materials or equipment weighing up to 15 pounds
Fluent in English (written and verbal)
Excellent verbal and written communication skills, including the ability to convey and exchange information in a clear and concise manner
Adequate hearing and vision (with corrective devices if necessary)
Ability to identify problems and use logic and related information to develop and implement solutions
Ability to work independently and carry out assignments to completion within the parameters of established policies and procedures
Ability to communicate clearly in-person, by phone, and electronically
Frequent use of computers, keyboard, and handheld/mobile devices
Competent with computers, email, virtual platforms, and Microsoft Office based programs
Ability to type for extended periods
Must be able to remain in a stationary position
Ability to maintain professionalism and safety in diverse environments
Consistently operate a computer and office equipment in a home-office setting
Diploma/GED required
Minimum 3+ years of clinical AR, practice management, and/or medical administration experience
Distraction-free home workspace with a secure internet connection

Nice To Haves

Bilingual in Spanish
Bachelor's degree in healthcare administration, business administration, or related field
Prior experience using eClinicalWorks

Responsibilities

Identify, notify, and work with internal team members on denial patterns and issues
Collaborate with direct manager and other team members to resolve issues timely
Evaluate patient accounts and take charge of insurance outstanding payments
Manage, track, and resolve complex denied and voided claims until the claim is paid
Achieve maximum reimbursement for services provided
Prepare and submit billing data and medical claims to insurance companies, including 837 and 1500 claims
Be proactive, creative, and flexible in determining, evaluating, researching, and resolving issues
Organize and prioritize multiple activities to meet all external and internal deadlines
Post payments accurately and timely to accounts
Collaborate with revenue cycle manager and operational leadership on frequent issues to consult and advise on how to correct errors
Develop and maintain claim resolution skills through continuous trainings, workshops, and education in collaboration with Revenue Cycle Manager
Check eligibility on a bi-monthly basis for clients and compiling list of clients with terminated Medi-Cal as needed and provide management and operations team reports
Prioritize tasks and create a tracking system of claims and health plans
Respond to requests and communication timely (within 24-48 hours)
Assist in the creation and review of billing procedures to ensure the company maintains compliance with local, state, and federal regulations
Perform other duties and projects assigned

Benefits

Make an impact: an organization who cares about its employees, communities, and the future of healthcare
Inclusivity: be a part of a workplace where you not only belong but also can be the best version of yourself
Growth: opportunities to develop and grow your career with us
Community: you are encouraged to have a voice, share your opinions, and have individual impact on the business
Paid Time Off: 12 holidays and up to 3 weeks of accrued PTO to rest and recharge plus additional time for sick, jury duty, bereavement, and reproductive loss
Work Life Balance: enjoy flexibility to maximize your well-being and success with our hybrid work model
Medical, Dental, & Vision Benefits: we cover up to 100% of your premium and 50% of your dependents depending on the plan
Flexible Spending, Health Savings & Dependent Care Accounts
Life/AD&D insurance funded 100% by Titanium Healthcare
Supplemental Short-Term Disability
Employee Assistance Programs
Protect your pet(s) with Pet Insurance
401(k) plan