Medical Biller - Van Nuys - Libertana

Description

JOB DESCRIPTION
Position: Medical Biller / Accounts Receivable (AR) Specialist
Pay Range: $27.00-$30.00 PER HR
Reporting To: Reimbursement Manager
Work Type: On-Site
POSITION SUMMARY:
The Medical Biller / AR Specialist Must have strong revenue cycle experience, including hands on work with CalAIM (Medi Cal managed care). The Medical Biller/ AR Specialist will own end to end billing, follow ups, denials management, and AR resolution to drive clean claims and steady cash flow.
REQUIRED QUALIFICATIONS:

• High school diploma or GED preferred.
• 3+ years of medical billing/AR follow up experience in a healthcare setting.
• Proven proficiency with Medi Cal managed care and commercial payers' claim workflows.
• Track record resolving denials, submitting appeals, and obtaining/correcting authorizations.
• Proficiency with EMR/EHR and billing systems; strong Excel skills (filters, sorting, lookups).
• Exceptional attention to detail, organization, and written communication.

PREFFERED QUALIFICATIONS:

• Direct CalAIM experience (e.g., ECM/CS or other CalAIM benefits), MCP portal submissions, and authorization management.
• Home health, or community-based services billing background.

ESSNENTIAL DUTIES AND RESPONSIBILITIES:
The following is a representation of the major duties and responsibilities of this position. The agency will make reasonable accommodations to allow otherwise qualified applicants with disabilities to perform essential functions.

• Prepare, review, and submit clean claims to Medi Cal, commercial payers, and managed care plans.
• CalAIM: submit and track claims to MCPs, verify authorizations, resolve denials tied to medical necessity, prior auth, referrals, and program eligibility; prepare professional appeal letters and retro-auth requests when applicable.
• Perform accurate charge entry, payment posting, and adjustments; reconcile remittances (ERA/EOB) and maintain precise documentation in EMR/billing systems.
• Work AR aging by payer and by program); identify denial patterns and escalate root causes with clear summaries.
• Answer billing inquiries from patients, providers, and MCPs with professional, timely communication.

PHYSICAL REQUIREMENTS:

• Stand, sit, talk, hear, reach, stoop, kneel and use of hands and fingers to operate computer, telephone, and keyboard on a frequent basis (up to 75% of the time).
• Close vision requirements due to computer work.
• Light to moderate lifting may be required (up to 25lbs).