Medical Billing Pro — Full-Cycle Claims & Reimbursements

AmeriPharma; Laguna Hills (CA); On-site; USD 55,000 - 75,000; Full time

Job summary

AmeriPharma in Laguna Hills, CA is seeking a Medical Biller II to manage the complete medical billing cycle for assigned accounts, ensuring timely and accurate reimbursement from government and commercial payers. This on-site role requires meticulous claim preparation and adherence to payer guidelines.

You will review patient accounts, obtain missing documentation, submit claims, verify CPT/ICD-10 coding, and resolve denials through appeals and corrections, while coordinating with Authorization,

Qualifications

• Minimum of two (2) years of experience in medical billing, accounts receivable, or revenue cycle management.
• Experience billing government and commercial insurance payers, including Medicare, Medicaid, and commercial health plans.
• Advanced knowledge of medical billing and reimbursement processes.
• Familiarity with CPT, HCPCS, ICD-10-CM codes and payer guidelines.

Responsibilities

• Review patient accounts to ensure documentation, authorizations, and insurance information are complete prior to billing.
• Prepare, review, and submit accurate medical claims to government and commercial payers in a timely manner.
• Verify coding, modifiers, place of service, units, and billing requirements per payer guidelines to maintain a clean claim rate.
• Research and resolve claim rejections, denials, underpayments, and payment variances.
• Submit corrected claims, reconsiderations, appeals, and supporting documentation as necessary.
• Collaborate with cross-functional teams to resolve billing-related issues and improve workflows.

Skills

Analytical thinking

Attention to detail

Communication skills

Organization

Problem solving

Education

High school diploma or equivalent

Tools

CPR+

Waystar

Avality

Job description

AmeriPharma in Laguna Hills, CA is seeking a Medical Biller II to manage the complete medical billing cycle for assigned accounts, ensuring timely and accurate reimbursement from government and commercial payers. This on-site role requires meticulous claim preparation and adherence to payer guidelines.

You will review patient accounts, obtain missing documentation, submit claims, verify CPT/ICD-10 coding, and resolve denials through appeals and corrections, while coordinating with Authorization,