Senior Medical Biller/Coder

We are seeking an experienced Senior Medical Biller/Coder to support and help oversee the full revenue cycle for a high-volume anesthesia practice. This role blends accurate anesthesia coding with hands-on billing operations, accounts receivable follow-up, and payer negotiations, especially for out-of-network claims. The ideal candidate is highly organized, deadline-driven, and confident communicating with both patients and insurance representatives to resolve claims efficiently and professionally. Key Responsibilities Support and help oversee the end-to-end billing cycle for a high-volume anesthesia billing operation, ensuring timely and accurate claim submission. Code, review, and validate anesthesia coding to ensure compliance and maximize appropriate reimbursement (including anesthesia base units, time units, modifiers, and documentation support). Manage accounts receivable (A/R) follow-up: work payer portals, identify underpayments/denials, submit corrected claims, and pursue appeals when necessary. Conduct proactive claim investigation and resolution, including eligibility/benefits checks when needed and coordination with internal teams to correct demographics, insurance, and clinical information. Participate in patient communications to provide anesthesia estimates and explain billing processes in a clear, professional, and compliant manner. Engage in routine negotiations with insurance companies regarding claims—particularly complex or high-dollar out-of-network claims—documenting all interactions and outcomes. Support IDR (Independent Dispute Resolution) arbitration processes: prepare claim packets, compile supporting documentation, coordinate timelines, and track dispute status through resolution. Identify trends in denials, payment variances, and payer behavior; recommend workflow improvements to reduce denials and accelerate cash flow. Maintain accurate notes and documentation in billing systems and trackers; ensure all work is logged for auditing, continuity, and reporting purposes. Collaborate with leadership to provide brief status updates on A/R performance, high-priority accounts, disputes, and negotiation pipelines. Ensure strict adherence to HIPAA, privacy requirements, and internal policies when handling PHI, patient inquiries, and claim documentation. Qualifications & Requirements Strong understanding of the claims processing lifecycle, including submissions, rejections, denials, appeals, and payment posting review. Deep working knowledge of California payers and common plan types (HMO/PPO/EPO), payer portals, and typical denial patterns. Demonstrated experience with out-of-network claims and a deep understanding of claims impacted by the No Surprises Act (including appropriate documentation and communication standards). Proficiency with Google Workspace, especially Google Sheets, as well as comfort working across multiple systems/portals. Excellent communication skills—especially strong, professional writing for payer correspondence, appeals, and patient communications. High attention to detail, strong time management, and ability to prioritize a high volume of tasks without sacrificing accuracy. Ability to work independently, maintain confidentiality, and meet deadlines consistently. Preferred Qualifications Anesthesia billing and coding experience is a significant advantage. Experience with IDR arbitration and out-of-network claims negotiations for anesthesia providers is strongly preferred. Familiarity with payment variance analysis, underpayment recovery, and building dispute/appeal templates and trackers. Experience working with anesthesia-specific documentation and workflows (e.g., anesthesia records, time documentation, surgeon/facility coordination). Key Skills Strong analytical and problem-solving skills for complex claim resolution Persistent, professional follow-up with payers and patients Strong organization and documentation habits Ability to communicate clearly and confidently in high-stakes billing scenarios Commitment to compliance, accuracy, and patient-centered service

Pay:

$32.00 - $40.00 per hour Expected hours: 40.0 per week

Benefits:

401(k) matching Dental insurance Employee discount Health insurance Paid time off

Work Location:

In person