Description We are looking for a Medical Billing Associate II to support reimbursement activities for a healthcare organization in Los Angeles, California. The Medical Billing Associate II is well suited for an organized individual who can manage billing follow-up, resolve claim issues, and help improve cash recovery across patient accounts. The Medical Billing Associate II role requires strong knowledge of insurance requirements, denial resolution, and account analysis within a fast-paced, team-driven environment. This role is a hybrid role. Candidates must be able to come into the office 1 day per week.

Responsibilities:

• Review submitted claims for accuracy, completeness, and proper routing to the appropriate insurance payer before and after submission.
• Investigate unpaid or denied claims by examining remittance details and payer correspondence, then take corrective action to move accounts toward payment.
• Analyze account activity, payment posting, and billing details to identify errors, correct discrepancies, and update balances when charges were processed incorrectly.
• Prepare corrected claims and formal appeals in accordance with payer-specific requirements, ensuring all required records and supporting documents are included.
• Communicate with insurance carriers and related parties to resolve reimbursement obstacles, clarify claim status, and accelerate collections.
• Confirm required authorizations and applicable documentation are attached to claims, and pursue retro-authorization when needed to support reimbursement.
• Process or escalate charge adjustments that cannot be billed, following established approval guidelines and documentation standards.
• Handle complex or escalated accounts, identify recurring billing issues, and contribute recommendations or special project support to strengthen workflow performance.
• Support team effectiveness by meeting productivity and quality expectations and assisting with peer guidance or onboarding support when needed.

Medi Requirements

• 3+ years of experience in medical billing, collections, or revenue cycle operations within a healthcare setting.
• Hands-on experience working denials, appeals, and payer follow-up to secure accurate and timely reimbursement.
• Knowledge of hospital billing practices and insurance plans, including HMO, PPO, and Medi-Cal.
• Ability to research patient accounts, evaluate payment discrepancies, and correct billing errors with strong attention to detail.
• Familiarity with authorization requirements and documentation needed for clean claim submission and appeal processing.
• Experience handling high-volume account workloads while maintaining accuracy, productivity, and service standards.
• Background in pediatrics billing or related healthcare specialty environments is preferred.
• Strong written and verbal communication skills for interacting with payers, internal teams, and other stakeholders.

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