Medical Biller — Workers' Comp Specialist

American Family Care; Fresno (CA); On-site; USD 29,000 - 34,000; 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 (AFC) is seeking an experienced Medical Biller with a strong background in California workers’ compensation processing. The role oversees the full billing cycle, ensuring accurate submission, timely reimbursement, and regulatory compliance.

The ideal candidate has 2+ years in medical billing, 1+ year in WC billing, and proficiency with CPT/ICD-10/HCPCS, EMR systems, and denial management. This is an on-site position offering comprehensive benefits and growth opportunities.

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 EMR and billing software.
• Strong organizational skills and attention to detail.
• Excellent verbal and written communication skills.

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 corrective action.
• Communicate with insurance carriers, claims adjusters, and attorneys.
• Maintain detailed documentation of all claim follow-up.
• Manage aging accounts and prioritize high-value accounts.
• Assist with appeals and reconsideration.
• Post payments and adjustments accurately.
• Reconcile accounts and identify outstanding balances.
• Collaborate with clinical staff to resolve reimbursement issues.
• Maintain organized billing records.
• Meet productivity and collection targets.

Skills

Medical billing

Workers’ Compensation billing

Attention to detail

Verbal and written communication

Organizational skills

Multitasking and deadlines

Billing terminology knowledge

Tools

EMR/billing software

Job description

American Family Care (AFC) is seeking an experienced Medical Biller with a strong background in California workers’ compensation processing. The role oversees the full billing cycle, ensuring accurate submission, timely reimbursement, and regulatory compliance.

The ideal candidate has 2+ years in medical billing, 1+ year in WC billing, and proficiency with CPT/ICD-10/HCPCS, EMR systems, and denial management. This is an on-site position offering comprehensive benefits and growth opportunities.