Location: Torrance, CA
Job Type: Full-time
Reports To: Supervisor
Salary: $23 per hour
Benefits: Medical, dental, vision and life insurance
About Us
HealthPro Solutions, Inc. is a dedicated medical billing company committed to providing efficient revenue cycle management services to healthcare providers. We pride ourselves on accuracy, compliance, and exceptional client service.
Position Overview
We are seeking an experienced Revenue Cycle Billing Specialist to join our team. The ideal candidate will be responsible for managing all aspects of the revenue cycle, from claim submission to payment posting and denial management for several clients. This role requires a detail-oriented professional with a strong understanding of medical billing processes, insurance guidelines, and coding principles.
Key Responsibilities
Claims Processing & Submission:
o Accurately review, prepare, and submit claims to insurance payers (Medicare, Medicaid, commercial insurance, and third-party payers, etc).
o Ensure compliance with payer requirements, CPT, ICD-10, and HCPCS coding guidelines.
o Follow up on outstanding claims and resubmit denied claims when necessary.
Revenue Cycle Management:
o Perform accounts receivable (A/R) follow-ups and work claim denials to maximize reimbursement.
o Identify and resolve billing errors or discrepancies to prevent revenue loss.
o Process patient payments and post insurance payments, including EOB (Explanation of Benefits) reconciliation.
Denial & Appeals Management:
o Investigate claim denials, determine appropriate corrections, and file appeals with insurance companies.
o Communicate with payers to resolve claim issues and expedite reimbursement.
Patient & Client Communication:
o Assist with patient billing inquiries and provide clear explanations of account balances.
o Work closely with providers and office staff to ensure proper claim documentation.
Compliance & Reporting:
o Maintain compliance with HIPAA, payer policies, and federal/state regulations.
o Generate and analyze billing reports to identify trends and opportunities for improvement.
o Stay updated on industry changes, coding updates, and payer policies.
Qualifications & Requirements
Education & Certification:
o High school diploma or equivalent (required).
o Certification in medical billing and coding (CPB, or similar) preferred.
Experience:
o Minimum of 2-3 years of experience in medical billing, revenue cycle management, or healthcare claims processing.
o Experience with Medicare, Medicaid, and commercial insurance payers.
o Knowledge of medical terminology, CPT, ICD-10, and HCPCS codes.
Skills & Abilities:
o Proficiency in electronic health records (EHR) and medical billing software.
o Strong analytical, problem-solving, and attention-to-detail skills.
o Ability to work independently and as part of a team.
o Excellent communication and organizational skills. Both written and verbal communication must be exceptional
Preferred Qualifications
Experience with MDsuite, AdvancedMD, and NextGen Enterprise preferred
Prior experience in a medical billing company or healthcare practice.
Work Schedule & Environment
Monday-Friday, 8 AM – 5 PM PST
Hybrid schedule; 3 days in office/2 days home
Office-based with occasional interaction with healthcare providers and insurance representatives
