Experienced Medical Biller/Front Office

DaMar Staffing; Salinas (CA); On-site; USD 42,000 - 64,000; Full time

Job summary

DaMar Staffing seeks a detail-oriented Medical Billing Specialist in Salinas, CA. You will handle insurance claims, verify patient eligibility, post payments, and follow up on denials while maintaining HIPAA compliance.

Requirements include 1–3 years in medical billing/collections, CPC/CCS/CMC certifications preferred, Associates degree, bilingual English/Spanish, and familiarity with systems like eMDs or Meditech. This is a full-time on-site role with a professional team.

Qualifications

• 1–3 years medical insurance/healthcare billing experience in a medical practice or health system.
• CPC, CCS, or CMC certifications required; CPEDC is a plus.
• Associates degree preferred in business administration or related field.

Responsibilities

• Perform duties in billing and collections duties, compliant with policies and regulations.
• Verify eligibility and benefits for upfront collection on deductibles and co-insurance.
• Enter charges according to insurance payors/contracts.
• Submit clean claims with documentation for payment.
• Follow-up on electronic and paper claims and post insurance payments.
• Identify problem accounts and follow up with patients and payers as needed.
• Maintain HIPAA confidentiality in all processes.

Skills

Bilingual English/Spanish

Medical billing

HIPAA

CPT/ICD coding

Payer communications

Team collaboration

Problem solving

Multitasking

Education

Associates degree

CPC/CCS/CMC certifications

CPEDC beneficial

Tools

eMDs

Meditech

10-key calculators

Job description

Job Description

Job Responsibilities:

• Performs all duties and responsibilities in a proficient, efficient, team-oriented manner (Examples as follows but not limited to)
• Scheduling Appointments
• Checking in/checking out patients
• Monitor Insurance claims by running appropriate reports and contacting insurance companies to resolve claims that are not paid in a timely manner- knowledge of questions to ask for proper processing.
• Accountable for being knowledgeable and understanding of all aspects of the billing and coding duties, maintains knowledge of and complies with established policies and procedures including government, insurance and third-party payer regulations.
• Verifying patient eligibility and benefits for upfront collection on unmet deductibles and co-insurance
• Enter charges accurately according to insurance payors/contracts
• Submitting clean claims by attaching necessary documentation for payment within the Revenue Cycle
• Follow-up on electronic claims and paper claims
• Posting insurance payments to patient accounts
• Submit all secondary claims when necessary
• Identify problem accounts and escape as appropriate.
• Work with patients and guarantors to secure payment on outstanding account balances.
• Refund money owed to patient or insurances
• Work with other offices to get necessary info to get claims processed.
• EOB functionality
• Other duties may be assigned

Proficiency in the following areas is required:

• Bilingual English and Spanish
• Knowledge of insurance guidelines including HMO/PPO, Medicaid, and other payer requirements and systems.
• Assures accuracy of all CPT, ICD, and HCPCS coding, through familiarity with coding modalities.
• Competent use of computer systems, software, and 10 key calculators. Must be able to become proficient on eMD’s, Meditech computer systems within a reasonable time after training (no more than 30 days).
• Effective communication capabilities for phone contacts with insurance payers to resolve issues.
• Efficient and effective customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse backgrounds and ages.
• Ability to work well in a team environment. Being able to triage priorities, and handle conflict in a judicious manner.
• Problem-solving skills to research and resolve discrepancies, denials, appeals, collections.
• A calm manner and patience working with either patients, coworkers or insurers during this process.
• Knowledge of accounting and bookkeeping procedures.
• Knowledge of medical terminology likely to be encountered in medical claims.
• Maintaining strict patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
• Ability to Multitask

Education and Experience Required

• Minimum of 1 to 3 year medical insurance/healthcare billing and collections experience in a medical practice or health system, with a deep understanding of medical billing rules and regulations
• Minimum of one of the following Medical coding Certifications through either AHIMA, AAPC, or PMI, with the following credentials CPC, CCS, or CMC certifications required. CPEDC an added benefit but not required.
• Associates degree, preferably in business administration or related field

A combination of education and experience will be considered

Salary DOE/DOQ

Company Description

Board Certified Pediatric Physician
Welcoming Professional Environment