Physician Billing Specialist

MemorialCare; Fountain Valley (CA); Hybrid; USD 47,000 - 66,000; Full time

Job summary

MemorialCare in Fountain Valley, CA is seeking a Physician Billing Specialist to manage daily billing tasks for physician services. The role requires contacting insurance companies, reviewing claims, and applying CPT and ICD-10 knowledge to ensure accurate payments.

This full-time, hybrid position emphasizes timely responses to payers, denial management, and collaboration with the billing team to maintain accuracy and efficiency across our payer communications.

Responsibilities

• Review daily tasks in the applications and as assigned.
• Contact insurance companies, other third-party payers regarding claims status and payments via telephone and written correspondence according to established standards.
• Respond to inquiries and correspondence from insurance companies, patient's and third party payers in a professional and timely manner.
• Rebill claims as necessary.
• Review and process denials from insurance companies, process for further review, identifying and initiating appeals as needed.
• Audit accounts for any necessary corrections, including updating insurance coverage information.
• Must have working knowledge of CPT and ICD-10 codes and payer policies.
• Be able to identify denial trends and report to management.
• Must be able to perform at or above assigned department quality.
• Must be able to fulfill other duties as assigned by management.

Job description

Title: Physician Billing Specialist

Location: Fountain Valley

Department: Physician Billing - Svc Staff

Status: Fulltime

Shift: Days (8hrs shifts) Hybrid

Pay Range: $22.50/hr - $31.57/hr

MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups - consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models.

Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.

Position Summary

Review daily assigned tasks through the applications and as assigned. Contact insurance companies, other third-party payers regarding claims status and payments via telephone and written correspondence according to established standards. Respond to inquiries and correspondence from insurance companies, patient's and third party payers in a professional and timely manner. Rebill claims as necessary. Review and process denials from insurance companies, process for further review, identifying and initiating appeals as needed. Audit accounts for any necessary corrections, including updating insurance coverage information. Must have working knowledge of CPT and ICD-10 codes and payer policies. Be able to identify denial trends and report to management. Must be able to perform at or above assigned department quality. Must be able to fulfill other duties as assigned by management.

Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities.

Health and wellness is our passion at MemorialCare - that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there's more... Check out our MemorialCare Benefits for more information about our Benefits and Rewards.