Physician Billing Specialist: Hybrid, Denials & Appeals

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

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.