Medical Billing Aged Specialist

Medical Billing Aged Specialist MDCS, Management Services Organization Brea, CA Job Details Full-time $18.00 - $18.50 an hour 4 hours ago Benefits Health insurance Dental insurance 401(k) Paid time off Vision insurance Qualifications X12 EDI Customer communication National Correct Coding Initiative (NCCI) guidelines Microsoft Outlook EDI Interpersonal skills Spreadsheets Health insurance policy knowledge HIPAA Patient management software Certified Professional Coder Electronic health record (EHR) management for billing and coding Attention to detail Medical explanation of benefits reviews Medical terminology Medical debt collection accounts Collections account management Patient collections management Full Job Description Position Summary We are seeking a detail-oriented and results-driven Medical Billing & Accounts Receivable Specialist to join our Revenue Cycle Management team. This role is responsible for reducing unpaid medical claims, maximizing reimbursement from insurance carriers, and improving overall accounts receivable performance. The ideal candidate will possess strong knowledge of medical billing, insurance follow-up, appeals management, and collections processes, while delivering exceptional customer service to patients and clients. Purpose of the Position Support the Team Leader, Billing & Collections, in managing client revenue collection activities. Ensure insurance companies provide accurate and timely reimbursement for submitted claims. Achieve month-over-month reductions in aged Accounts Receivable (A/R), particularly balances over 90 days. Provide professional and courteous service to patients while explaining account balances and billing inquiries. Identify, investigate, and resolve outstanding insurance claims and patient account issues. Analyze reports and work queues to prioritize collection efforts and maximize reimbursement. Assist with the timely processing and reconciliation of claim payments. Maintain complete and accurate documentation of all collection and follow-up activities. Support special projects and initiatives assigned by management. Primary Responsibilities Insurance Follow-Up & Collections Manage assigned insurance claims and collection accounts through resolution. Conduct collection calls and written correspondence with insurance companies and patients. Investigate and resolve denied, underpaid, and unpaid claims. Identify and address insurance discrepancies, short payments, and billing issues. Follow up consistently with insurance carriers until claims are paid or appropriately resolved. Initiate, track, and resolve payer appeals and reconsiderations. Monitor account aging and prioritize high-value and aged accounts. Maintain detailed documentation of account actions, payer responses, and follow-up plans. Revenue Cycle Management Analyze Explanation of Benefits (EOBs) and remittance advice for payment accuracy. Process insurance payments and reconcile account balances. Verify refund requests and medical record requests. Ensure compliance with payer guidelines and company policies. Utilize coding edits and billing best practices to optimize reimbursement. Assist with claim processing and billing support functions as needed. Reporting & Process Improvement Create and maintain spreadsheets, reports, and productivity metrics. Provide regular updates to supervisors and management regarding collection performance. Assist in developing and improving collections policies, procedures, and workflows. Support training and mentoring of new billing and collections staff. Participate in departmental projects and continuous improvement initiatives. Secondary Responsibilities Research and resolve patient account disputes. Address patient insurance questions and concerns professionally. Provide backup support for claim submission and billing functions. Assist other team members with account resolution activities as needed. Required Knowledge & Skills Strong knowledge of medical billing and revenue cycle management. Proficiency in medical terminology. Thorough understanding of ICD-10, CPT, and HCPCS coding. Knowledge of coding modifiers and Correct Coding Initiative (CCI) guidelines. Experience working with commercial, government, in-network, and out-of-network insurance plans. Ability to interpret EOBs, denial codes, and payer correspondence. Proficiency with Microsoft Office Suite, including Excel and Outlook. Experience using Practice Management Systems (PMS) and Electronic Health Records (EHR). Strong analytical, problem-solving, and organizational skills. Excellent verbal and written communication abilities. Preferred Qualifications Certified Medical Coder (CPC, CCS, or equivalent) preferred. Bilingual skills preferred but not required. Experience training or mentoring team members is a plus. Experience Requirements Minimum of 1 year of medical billing education or equivalent experience. Minimum of 1 year of medical billing experience. Minimum of 1 year of insurance follow-up, accounts receivable collections, or specialty medical billing experience. Demonstrated success in reducing aged A/R and resolving unpaid claims. Key Performance Indicators (KPIs) Monthly reduction of aged Accounts Receivable balances. Timely resolution of unpaid and denied claims. Processing of all EOBs within 48 hours of receipt. Daily resolution of EDI claim errors. Professional handling of patient and client billing inquiries. Consistent achievement of collection and reimbursement goals. Accurate and timely account documentation. Daily review and response to Outlook communications. Contribution to client cash flow through effective revenue recovery efforts. Desired Attributes Results-oriented with a strong collections mindset. Self-motivated and capable of working independently. Team player who collaborates effectively with colleagues and leadership. High attention to detail and commitment to accuracy. Professional, respectful, and patient-focused approach. Ability to thrive in a fast-paced, deadline-driven environment. Strong initiative, planning, and process improvement skills. Commitment to confidentiality and HIPAA compliance.

Pay:

$18.00 - $18.50 per hour

Benefits:

401(k) Dental insurance Health insurance Paid time off Vision insurance

Work Location:

In person