Medical Billing Specialist

Robert Half • La Puente, CA • 6h ago

Description

A Larger Medical Center in the La Puente Area is in the need of a d Medical Billing Specialist with strong Medi-Cal insurance experience. The Medical Billing Specialist will play a key part in managing the revenue cycle and ensuring accurate billing for Medi-Cal programs. The Medical Billing Specialist must have expertise to maintain compliance with provider guidelines and optimize reimbursement processes. Experience in OBGYN and/or Perinatal Services is a bit plus.

Responsibilities:

Verify patient eligibility for Medi-Cal and confirm Managed Care Plan assignments for services rendered.

Prepare and submit claims accurately using appropriate coding and modifiers, including electronic equivalents of CMS-1500 forms.

Post payments, reconcile accounts, and ensure adjustments and write-offs align with contractual requirements.

Analyze denied or underpaid claims, identify issues, and resubmit them to secure proper reimbursement.

Manage appeals by reviewing Explanation of Benefits and engaging with the appeals process to resolve claim discrepancies.

Maintain secure and compliant records of Protected Health Information used in billing activities.

Assist healthcare providers with billing inquiries and support case management practices to enhance revenue.

Ensure all billing activities align with Medi-Cal Provider Manual and Managed Care Plan guidelines.

Collaborate with internal teams to streamline billing processes and improve efficiency.

Requirements

Minimum of three years of experience in medical billing, with at least one year focused on Medi-Cal programs.

Proven ability to handle claims denials and appeals processes effectively.

Strong knowledge of medical billing codes, including Z1032, Z1034, and Z1036, and appropriate modifiers such as XP and 95.

Familiarity with telehealth billing practices and compliance requirements.

Experience in medical billing and specialized areas such as OBGYN.

Proficiency in payment posting, data reconciliation, and financial adjustments.

Understanding of Protected Health Information (PHI) security and compliance standards.

Excellent organizational and communication skills to collaborate with healthcare providers and internal teams.

Robert Half is the world's first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more.

Robert Half will consider for employment qualified applicants with arrest or conviction records in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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