Patient Support Representative

AppleOne Employment Services; Fremont (CA); On-site; USD 42,000 - 65,000; Full time

Job summary

AppleOne Employment Services seeks a detail-oriented Medical Billing & Insurance Specialist to support revenue cycle operations in Fremont, CA. You will handle insurance verification, claims processing, patient billing support, payment posting, and account reconciliation.

The ideal candidate has 2+ years in medical billing, familiarity with CPT/ICD-10, and strong communication skills to assist patients and carriers while maintaining confidentiality.

Qualifications

• 2+ years in medical billing, insurance verification, AR or revenue cycle.
• Knowledge of medical insurance plans, billing procedures and claims.
• Experience with insurance carriers and claim follow-up.
• Strong customer service and communication skills.
• Proficiency with Microsoft Office, including Excel and Outlook.
• High attention to detail and ability to multi-task.

Responsibilities

• Insurance Coordination: verify eligibility, submit claims, research denials, prepare appeals, and communicate with carriers.
• Patient Communication: answer inquiries, explain benefits and payments, resolve concerns, maintain confidentiality.
• Billing & Payment Processing: generate statements, post payments, reconcile balances, monitor AR, and document records.

Skills

Bilingual Spanish-English

Customer service

Communication skills

Excel & Outlook

Attention to detail

Multitasking

Tools

MS Office suite

EHR software

Job description

A local client is looking to hire a detail-oriented and customer-focused Medical Billing & Insurance Specialist to support our revenue cycle operations and provide exceptional service to patients. This role is responsible for insurance verification, claims processing, patient billing support, payment posting, and account reconciliation. The ideal candidate will have experience working with insurance carriers, resolving billing issues, and communicating effectively with patients regarding their accounts and financial responsibilities.

Key Responsibilities:

Insurance Coordination

• Verify patient insurance eligibility, coverage, and benefits.
• Submit insurance claims accurately and timely.
• Research and resolve denied, rejected, or underpaid claims.
• Prepare and submit claim appeals and supporting documentation.
• Communicate with insurance carriers regarding claim status and reimbursement issues.

Patient Communication

• Answer incoming patient inquiries regarding charges, billing statements, and account balances.
• Explain insurance benefits, co-pays, deductibles, and out-of-pocket expenses.
• Assist patients in understanding billing processes and payment options.
• Resolve billing concerns professionally and escale complex issues as needed.
• Deliver excellent customer service while maintaining patient confidentiality.

Billing & Payment Processing

• Generate and distribute patient billing statements.
• Post daily payments, insurance remittances, and adjustments accurately.
• Reconcile account balances and resolve discrepancies.
• Monitor accounts receivable and assist with collection efforts when appropriate.
• Maintain accurate billing records and documentation.

Qualifications

Required

• 2+ years of medical billing, insurance verification, accounts receivable, or health care revenue cycle experience.
• Knowledge of medical insurance plans, billing procedures, and claims processing.
• Experience working with insurance carriers and claim follow-up.
• Strong customer service and communication skills.
• Proficiency with Microsoft Office Suite, including Excel and Outlook.
• Strong attention to detail and ability to manage multiple priorities.

Preferred

• Experience using electronic health records (EHR) and medical billing software.
• Knowledge of CPT, ICD-10, and HCPCS coding principles.
• Experience with claim appeals, denials management, and payment reconciliation.
• Healthcare, medical office, hospital, or clinic experience.

Ideal Candidate

The ideal candidate is organized, analytical, and solution-oriented with a strong understanding of medical billing and insurance processes. They are comfortable communicating with patients and insurance providers, resolving account discrepancies, and ensuring accurate and timely reimbursement while delivering a positive patient experience.

Required Qualifications

• Fluent in both Spanish and English
• Experience in:
  • Human services
  • Customer service
  • Administrative support
  • Community outreach
  • Social services or related fields
• Strong communication, organizational, and problem-solving skills
• Proficiency with:
  • Microsoft Office
  • Google Workspace
• Ability to build relationships and work effectively with diverse populations
• Reliable personal vehicle for occasional community outreach activities, meetings, and donation pickups

Equal Opportunity Employer / Disabled / Protected Veterans

The Know Your Rights poster is available here:

https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf

The pay transparency policy is available here:

https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf

For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.

https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf

We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.