Medical Biller w/ California Insurance Experience (Bilingual Spanish - English)
LocationColombia
Work moderemote
Typefull-time
DepartmentMedVirtual
Company size11+ people
First seen1w ago
Last seen3d ago
[Kindly submit your updated English resume]
About the role
We are seeking a highly skilled Full-Cycle Medical Biller with extensive experience in U.S. healthcare billing, particularly within California insurance systems. This role requires a deep understanding of the end-to-end billing cycle, including claim submission, payment posting, accounts receivable (A/R), and denial management.
The ideal candidate is a proactive problem-solver who can independently navigate complex payer systems while also supporting front-office functions, including patient intake and communication.
Key Responsibilities:
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Manage the full-cycle medical billing process from claim creation to final payment resolution
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Perform accurate claim submission and generation using ICD-10 and CPT coding
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Handle payment posting, reconciliation, and adjustments
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Monitor and manage Accounts Receivable (A/R) to ensure timely collections
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Conduct denial management and follow-ups, including appeals and resubmissions
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Perform insurance verification and eligibility checks
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Process and manage prior authorizations for procedures and services
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Navigate payer portals (e.g., Availity and payer-specific systems) for claims, eligibility, and follow-ups
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Communicate with insurance providers regarding claim status, denials, and authorizations
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Support front-office operations, including patient intake and insurance-related inquiries
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Ensure compliance with medical necessity documentation and payer requirements
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Collaborate with providers and internal teams to resolve billing discrepancies
Requirements
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2+ years of end-to-end medical billing experience (REQUIRED)
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Strong proficiency in:
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Claim submission and generation
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ICD-10 and CPT coding
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Payment posting
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A/R management
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Denial handling and follow-ups
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Extensive experience with:
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Insurance verification and prior authorizations (REQUIRED)
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Hands-on experience working with:
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Medicare
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Medicaid / Medi-Cal (or state equivalent)
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Medicare Advantage plans
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HMO plans in California (REQUIRED)
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Deep familiarity with U.S. insurance portals (e.g., Availity, payer portals)
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Strong understanding of medical necessity requirements
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Excellent communication and problem-solving skills
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Willingness to work in US time zones (PST, EST, CST).
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High school diploma or equivalent.
Preferred Qualifications
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Experience working with Independent Physician Associations (IPAs)
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Background in Primary Care and/or ENT (Ear, Nose, and Throat) specialties
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Experience with DrChrono EHR (preferred but not required)
System and Work Setup Requirements:
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Internet: Minimum speed of 25 Mbps or higher, with a reliable backup connection available in case of power outages or service provider issues.
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Processor: Intel Core i5 7th Generation or higher (or equivalent).
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Memory: 8 GB RAM.
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Storage: 256 GB SSD or HDD with at least 50% free space available.
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Webcam: 720p resolution or higher.
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Operating System: Windows 10 or later (or equivalent).
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Audio Equipment: Noise-canceling earphones or headset.
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Workspace: A designated, quiet, and organized workspace free from distractions to ensure productivity and focus.