California Workers’ Comp Medical Billing Specialist

American Family Care, Inc.; Fresno (CA); Hybrid; USD 45,000 - 75,000; Full time

Benefits offered by this job

Health insurance

Training & development

Vision insurance

401(k) matching

Dental insurance

Paid time off

Savings bank

Job summary

American Family Care in Fresno, CA is seeking an experienced Medical Biller with a focus on Workers’ Compensation to manage end-to-end billing, submissions, and reimbursement while ensuring compliance with state and federal regulations.

You will verify claim details, monitor aging A/R, handle denials and appeals, and collaborate with clinical and administrative staff to resolve issues that affect payment. The role emphasizes accuracy, productivity, and timely reporting to management.

Qualifications

• Minimum of 2 years of medical billing experience.
• Minimum of 1 year of Workers’ Compensation billing experience.
• Knowledge of CPT, ICD-10, and HCPCS coding.
• Experience with claim denial management and appeals.
• Proficiency with electronic medical records (EMR) and billing software.
• Strong knowledge of medical terminology and healthcare documentation standards.
• Excellent verbal and written communication skills.
• Ability to manage multiple priorities and meet deadlines.

Responsibilities

• Prepare and submit accurate California workers’ compensation medical bills and claims.
• Verify claim information, insurance coverage, adjuster information, and billing requirements.
• Monitor claims from submission through payment.
• Follow up on unpaid, delayed, rejected, and denied claims.
• Research and resolve billing discrepancies.
• Review EOBs, payment reports, denials, and adjustments.
• Identify underpayments and take appropriate corrective action.
• Communicate professionally with insurance carriers, claims adjusters, bill review companies, attorneys, and other representatives.
• Maintain detailed documentation of all claim follow-up.
• Manage aging accounts and prioritize high-value and problem accounts.
• Assist with appeals, reconsideration, and other billing-related correspondence.
• Post payments and adjustments accurately.
• Reconcile accounts and identify outstanding balances.
• Work closely with clinical and administrative staff to resolve issues affecting reimbursement.
• Maintain accurate and organized billing records.
• Meet established productivity, accuracy, A/R, and collection goals.
• Perform other duties as assigned

Skills

Medical billing

Workers’ Compensation

Attention to detail

Organization

Tools

EMR

Billing software

Job description

American Family Care in Fresno, CA is seeking an experienced Medical Biller with a focus on Workers’ Compensation to manage end-to-end billing, submissions, and reimbursement while ensuring compliance with state and federal regulations.

You will verify claim details, monitor aging A/R, handle denials and appeals, and collaborate with clinical and administrative staff to resolve issues that affect payment. The role emphasizes accuracy, productivity, and timely reporting to management.