Medical Billing & Eligibility Specialist

Agendia; Irvine (CA); On-site; USD 30,000 - 33,000; Full time

Job summary

Agendia in Irvine, CA is seeking a Billing Associate to manage all aspects of medical billing including eligibility verification and order entry. The role requires attention to detail and knowledge of CPT/ICD-10, with experience using Salesforce and MS Office.

You will collaborate with internal teams and external payors to ensure accurate submissions and timely reimbursements, while maintaining data integrity and high-quality documentation.

Qualifications

• High school diploma or GED required; Medical Billing Certification or equivalent experience preferred.
• 3+ years related experience preferred.
• CPT and ICD-10 knowledge required.
• Advanced knowledge of Microsoft Office products.

Responsibilities

• Primary Billing
• QC of SFDC order entry and payor selections
• Data entry and transfer daily to the Billing System
• Generate charges and electronic/paper claims for payors
• Use Salesforce for tasks and follow-up with collectors, pre-authorizations, or Patient Care Specialist
• Manage interface errors and upfront claim rejections
• Overflow duties: word processing, data entry, internet research
• Interface with insurers, doctors, and hospitals to obtain records and insurance info
• Verify eligibility and benefits; enter details in Salesforce
• Verify coverage criteria per payer policy; interact with Customer Care
• Analyze data to prepare charges and identify missing information
• Escalate issues to Reimbursement Supervisor/Manager
• Review pathology reports for coverage criteria
• Maintain client relationships related to Benefit and Eligibility
• Assist in developing new procedures to improve productivity
• Collaborate with Reimbursement leadership to resolve issues

Skills

Analytical thinking

Attention to detail

Organizational skills

Verbal/written communication

Problem resolution

Data entry

Multi-tasking

Education

High School diploma or general education degree

Medical Billing Certification or work experience equivalency

3+ years related experience preferable

Tools

Microsoft Excel

Microsoft Word

Microsoft Outlook

Salesforce (SFDC)

Job description

Agendia in Irvine, CA is seeking a Billing Associate to manage all aspects of medical billing including eligibility verification and order entry. The role requires attention to detail and knowledge of CPT/ICD-10, with experience using Salesforce and MS Office.

You will collaborate with internal teams and external payors to ensure accurate submissions and timely reimbursements, while maintaining data integrity and high-quality documentation.