Medical Billing Specialist I (Temporary)

Cap Diagnostics LLC•Irvine, CA

4d•Onsite

About The Position

The Medical Billing Specialist I supports the billing team and the Director of Revenue Cycle by performing a wide range of administrative duties to help Pathnostics maintain accurate, compliant, and timely billing for services rendered. The temporary position is estimated to end in January 2027.

Requirements

At least 2 years’ experience of customer service (phone & email) within the healthcare field, laboratory, or diagnostics industry is highly preferred
At least 1 year of experience with computerized billing systems or Revenue Cycle Management (RCM) software, Xifin or similar is preferred
Ability to adapt to changing procedures, policies, work environment, and responsibilities
Ability to communicate effectively, document, and follow instructions with a high level of accuracy
A patient-first, mission-oriented mindset

Nice To Haves

Working knowledge of health care billing procedures, documentation, regulations, payment cycles, and standards.
Experience in medical collections, payment posting, medical coding, and denials.
CPT and ICD-10 coding knowledge.
Ability to interpret explanations of benefits.
Out-of-network experience is helpful.

Responsibilities

Answer telephone promptly and in a polite and professional manner.
Handle a high volume of inbound calls in a timely manner.
Follow communication “scripts” when handling different topics.
Investigate and respond to all phone inquiries from patients and clients concerning invoices, pricing, account status, claim status, and eligibility issues.
Secure and enter necessary insurance and demographic information to submit and/or re-bill insurance claims as needed.
Work with appropriate departments or staff to resolve questions and/or issues related to billing, coding, and denials.
Explain patient statements and explanation of benefits including charges, insurance allowable, adjustments, coinsurance, and payments.
Document all patient interactions in the billing system and call logs in a concise, accurate, and timely manner.
Monitors billing messages and places outbound calls.
Comply with all applicable HIPAA policies and procedures.
Resolve unbillable accessions by utilizing various tools available, including contacting clients, patients, and/or sales reps to retrieve missing information and re-education.
Track, monitor, and report billing discrepancies.
Coordinate with an outsourced billing company to implement company policies and procedures as it relates to the billing process.
Address billing-related inquiries from patients, clients, and sales reps received by either inbound phone calls or emails.
Perform collection efforts by obtaining medical records and supporting documents.
Upload medical records and supporting documents to insurance companies’ websites.
Other duties as assigned.