Medical Biller/AR Specialist

MVML INC; Irvine (CA); On-site; USD 48,000 - 70,000; Full time

Job summary

MVML INC is seeking a detail-oriented Medical Biller/AR Specialist to join our Irvine-based team. You will manage the end-to-end medical billing and revenue cycle, submitting claims, reviewing denials, and communicating with providers, insurers, and patients.

The ideal candidate has strong knowledge of CPT/ICD-10, Medicare/ Medi-Cal processes, and excellent analytical and organizational skills. Experience with ERAs/EOBs and HIPAA/PHI guidelines is required.

Qualifications

• Knowledge of CPT/ICD-10 codes and modifiers.
• Experience with commercial insurance, Medicare, and Medi-Cal.
• Strong communication and analytical skills.
• Attention to detail and organizational skills.
• Toxicology billing experience a plus.
• Medical billing certification a plus.
• Coding experience a plus.

Responsibilities

• Review high volume of claims to ensure billing guidelines.
• Submit electronic claims accurately and timely.
• Review EOB denials and underpayments for resubmission/appeals.
• Follow up on claims status through portals and phone.
• Verify benefits and obtain authorizations when required.
• Maintain productivity and quality levels per management.
• Adhere to HIPAA and PHI guidelines.

Skills

Medical terminology

CPT codes

ICD-10 coding

Modifiers

Claims submission

Communication skills

Analytical skills

Attention to detail

Organizational skills

HIPAA/PHI compliance

Toxicology billing experience

Education

Medical billing certification

Job description

We are seeking a detail-oriented Medical Biller/AR Specialist to join our dynamic team. As a Medical Biller/Specialist, you will play a crucial role in ensuring the accurate and timely processing of medical claims, facilitating efficient reimbursement, and maintaining compliance with healthcare regulations. You will work closely with healthcare providers, insurance companies, and patients to manage the billing and revenue cycle, contributing to the financial health of our organization.Responsibilities:Review high volume of claims to ensure they meet billing guidelines.Submit high volume of electronic claims accurately and timely.Submit claims to secondary insurance with appropriate supporting documents.Effectively review EOB denials and underpayments to determine best course of action (resubmission/appeals).Perform follow ups and obtain claims status through insurance portals and over the phone.Perform verification of benefits and obtain authorizations when required.Maintain productivity and quality levels set by management.Adheres to all HIPPA and PHI guidelines.Qualifications:Knowledge of medical terminology, CPT codes, ICD-10 codes, and modifiers.Experience with commercial insurance, Medicare, and Medi-cal.knowledge of EOBs and ERAs.Excellent communication and analytical skills.Attention to detail and strong organizational skills.Toxicology billing experience a plus.Medical billing certification a plus.Coding experience a plus.