Patient Billing & Claims Specialist I

North East Medical Services; Daly City (CA); On-site; USD 52,000 - 78,000; Full time

Benefits offered by this job

Competitive benefits package

401(k) company contribution

Free medical, dental and vision for员工及

Job summary

North East Medical Services is seeking a Patient Account Specialist I to manage claims for FQHC and fee-for-service care in a fast-paced environment. You will verify billing accuracy, resolve denials, and respond to payer inquiries, while maintaining HIPAA confidentiality.

You will work with Epic PB Resolute, stay current on CPT/ICD-10 coding, and coordinate with physicians, insurance companies, and staff to ensure timely reimbursement.

Qualifications

• AA/AS degree required; a four-year degree preferred or equivalent with 3 years healthcare experience.
• Experience in FQHC or healthcare billing is preferred.
• Familiarity with CPT/ICD-10 and payer requirements.

Responsibilities

• Reviews, edits, processes, and submits electronic and hardcopy claims for various payers.
• Maintains knowledge of billing requirements for Medi-Cal, Medicare, and private payers.
• Resolves aging reports and outstanding claims to minimize delays.
• Responds to payer requests and remittance advices professionally.
• Addresses patient inquiries and follows up on complex issues with staff.
• Posts charges and submits claims for physicians’ hospital visits.
• Trains Billing and front desk staff in multiple departments.
• Acts as liaison between physicians, payers, and third-party organizations.

Skills

Analytical skills

Communication skills

Bilingual English/Chinese

Microsoft Excel

Education

AA/AS degree required

Bachelor's degree preferred

Healthcare experience optional

Tools

Epic PB Resolute

Job description

North East Medical Services is seeking a Patient Account Specialist I to manage claims for FQHC and fee-for-service care in a fast-paced environment. You will verify billing accuracy, resolve denials, and respond to payer inquiries, while maintaining HIPAA confidentiality.

You will work with Epic PB Resolute, stay current on CPT/ICD-10 coding, and coordinate with physicians, insurance companies, and staff to ensure timely reimbursement.