Medical Billing Specialist: Non-Governmental Payers

Kpc Global Medical Centers Inc.; Hemet (CA); On-site; USD 30,000 - 43,000; Full time

Job summary

KPC Global Medical Centers Inc. in Hemet, CA is hiring a full-time Biller to manage third-party claims for non-governmental payers. You will submit primary and secondary claims using a billing editor, ensuring timely processing and accuracy.

Requirements include at least 2 years in a hospital billing environment, knowledge of CPT/HCPCS/HIPAA/UB04, and strong documentation skills. The role emphasizes accuracy and adherence to regulatory standards.

Qualifications

• Knowledge of CPT, HCPCS, HIPAA, UB04, Compliance and Regulatory issues.
• Knowledge of billing systems and software applications.

Responsibilities

• Ensure timely submission of non-governmental claims in the billing editor; submit primary and secondary claims electronically or hardcopy.
• Monitor billing editor for correct claim edits and report findings to management.
• Reconcile complex accounts (split payments, interim claims, benefits exhaustion).
• Document actions clearly in account notes with dates, contacts, and submission details.
• Identify payer trends and report insights to management.
• Maintain productivity and quality within guidelines; aim for team average or above.
• Review 72-hour report for overlap issues before the claim is billed.
• Handle rejected claims daily and complete the Late Charge report.
• Other duties as assigned.

Skills

CPT/HCPCS knowledge

HIPAA compliance

UB04 knowledge

Billing systems

Education

HS / Some college preferred

Tools

Billing editor software

Job description

KPC Global Medical Centers Inc. in Hemet, CA is hiring a full-time Biller to manage third-party claims for non-governmental payers. You will submit primary and secondary claims using a billing editor, ensuring timely processing and accuracy.

Requirements include at least 2 years in a hospital billing environment, knowledge of CPT/HCPCS/HIPAA/UB04, and strong documentation skills. The role emphasizes accuracy and adherence to regulatory standards.