Senior Medical Billing & Claims Leader

OneOncology; Orange (CA); Sur place; USD 32 000 - 51 000; Plein temps

Résumé du poste

The Los Angeles Cancer Network in Orange, California is seeking a Senior Billing & Claims Specialist to lead medical billing and claims processing for a physician practice. You’ll verify insurance, monitor denial trends, and ensure timely reimbursement in a fast-paced healthcare environment.

Candidate should have 3–5 years of medical billing experience, CPT/ICD-10-CM coding knowledge, and proficiency with EHR and billing software.

Qualifications

• 3–5 years of medical billing and claims experience, preferably in a physician practice or specialty healthcare setting.
• Strong knowledge of CPT, ICD-10-CM, HCPCS coding and billing requirements.
• Experience with commercial insurance, Medicare, and Medi-Cal claims.
• Proficiency with EHR, practice management systems, and billing software.

Responsabilités

• Review, prepare, and submit medical claims to insurance companies and other third-party payers.
• Verify patient insurance eligibility, benefits, and authorization requirements as needed.
• Monitor claim status and follow up on unpaid, denied, and rejected claims to support timely reimbursement.
• Investigate and resolve claim denials, billing discrepancies, and payment variances.
• Review EOBs and ERAs to ensure accurate payment posting and reimbursement.
• Identify trends in claim denials and recommend process improvements to reduce billing errors and improve collections.
• Research payer policies, reimbursement guidelines, and billing requirements.
• Communicate with insurance representatives, patients, and internal departments to resolve billing and claims issues.
• Maintain accurate billing documentation and ensure compliance with applicable healthcare regulations, payer requirements, and organizational policies.
• Assist with accounts receivable follow-up, aging reports, and revenue cycle reporting.
• Support and mentor billing team members by sharing best practices and providing guidance on complex claims.

Connaissances

Medical billing

Insurance claims

Analytical thinking

Communication

Independence

Formation

High school diploma

Billing/healthcare administration training

Outils

EHR software

Billing software

Practice management systems

Description du poste

The Los Angeles Cancer Network in Orange, California is seeking a Senior Billing & Claims Specialist to lead medical billing and claims processing for a physician practice. You’ll verify insurance, monitor denial trends, and ensure timely reimbursement in a fast-paced healthcare environment.

Candidate should have 3–5 years of medical billing experience, CPT/ICD-10-CM coding knowledge, and proficiency with EHR and billing software.