A Billing Specialist performs administrative work at financial institutions and banks that handle bills, receipts, and invoices. Manages the status of client accounts and tracks financial records, charges, and receipts of the accounts.
Medical Billing Specialist Paragon Health Group Newport Beach, CA Job Details Full-time $24 - $28 an hour 2 hours ago Qualifications Medical coding for surgical records
Full Job Description Job Overview Insurance Biller/ Medical Billing Specialist Company:
Paragon Health Group Employment Type:
Full-Time About Us Paragon Health Group is a growing healthcare management organization specializing in spine surgery and pain management. We are seeking an experienced Insurance Biller who is knowledgeable in specialty billing, reimbursement optimization, and revenue cycle management. The ideal candidate is proactive, detail-oriented, and committed to maximizing insurance reimbursement while maintaining compliance with payer guidelines. Position Summary The Insurance Biller is responsible for the complete insurance billing cycle, including claim submission, denial management, payment posting, reimbursement analysis, and accounts receivable follow-up. This role requires prior experience billing for spine surgery and pain management procedures and a strong understanding of specialty-specific CPT, ICD-10, HCPCS, and modifier usage. Accurate claims submission and reimbursement optimization are essential responsibilities of this position. Essential Responsibilities Submit accurate electronic and paper insurance claims in a timely manner. Bill for spine surgery and pain management procedures, ensuring accurate coding and claim submission. Review operative reports and documentation to verify appropriate CPT, ICD-10, HCPCS, and modifier usage. Monitor and follow up on outstanding claims to ensure timely reimbursement. Research and resolve claim denials, underpayments, and payment discrepancies. Submit corrected claims and appeals as necessary. Post insurance payments, adjustments, and contractual write-offs accurately. Research and monitor payer fee schedules and reimbursement rates to ensure claims are reimbursed appropriately and identify opportunities to maximize collections. Analyze Explanation of Benefits (EOBs) and investigate underpayments based on contracted payer rates. Maintain accurate billing records and documentation. Collaborate with providers and administrative staff to resolve billing issues. Maintain compliance with HIPAA, Medicare, commercial payer guidelines, and industry billing regulations. Qualifications Minimum of 3 years of medical insurance billing experience required. Previous billing experience in spine surgery and/or pain management is required. Thorough knowledge of spine and pain management CPT, ICD-10, HCPCS, and modifier coding. Experience with Medicare, commercial insurance, workers' compensation, and managed care plans. Strong understanding of insurance reimbursement methodologies, fee schedules, and contract analysis. Experience appealing denied or underpaid claims. Proficiency with EMR and medical billing software. Excellent organizational skills with strong attention to detail. Ability to work independently and efficiently manage multiple priorities. Preferred Qualifications CPC, CPB, or other medical billing/coding certification preferred. Experience with ambulatory surgery center (ASC) billing is highly preferred. Familiarity with prior authorizations and surgical revenue cycle management. Why Join Paragon Health Group? Competitive compensation based on experience Collaborative and supportive team environment Opportunity to grow with a rapidly expanding organization Professional development opportunities Make a meaningful impact by improving revenue cycle performance and supporting high-quality patient care If you have experience in spine surgery and pain management billing and are passionate about maximizing reimbursement while maintaining billing accuracy, we encourage you to apply.
