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MV
Monte Vista Childcare Center
Medical Biller- Intermediate Care Facilities (ICF/DDN & DDH)
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Based on California data
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What they do
A Medical Biller handles payments and financial transactions between health care providers and patients. Manages systems for mailing bills and collecting and recording payments. Works in healthcare facilities and hospitals.
$49,479 / year median in California
+2% projected growth
Job Description
Job Summary The Billing Specialist is responsible for independently managing claims submissions, payment postings, and communication with health plans and clearinghouses. This role requires a strong understanding of Medi-Cal, Medicare, Molina, IEHP, and other managed care payers. The ideal candidate is proactive, resourceful, and capable of identifying and resolving billing errors or denials to ensure timely reimbursement for services rendered. Duties Prepare and submit accurate claims for Room and Board and Nursing Services using Office Ally, mbill, and Availity. Monitor daily billing activity, including eligibility verification and tracking of outstanding claims via aging reports Conduct timely follow up on rejected, denied, or underpaid claims, including appeals and resubmissions Reconcile admittance advice (RA) with billed claims to ensure accurate payment postings Communicate with Medi-Cal and managed care plans to clarify issues and secure resolutions Collaboration with facility leadership and Nursing teams to ensure billing documentation is accurate and aligned with care plans. Requirements Bachelor Degree in Related Fields Proficient in Office Ally, mbill, and Availity platforms Solid knowledge of Medi-Cal, Medicare, Molina, and IEHP billing and denial resolution processes Ability to read and interpret Explanation of Benefits (EOBs), Remittance Advice (RA) forms, and Medicaid payment structures Familiarity with Google Docs, Sheets, Drive, and cloud based claim portals Muss possess a valid drivers license and reliable transportation Preferred Qualifications, not required Familiarity with CDPH, DDS, or Regional Center documentation requirements Experience in payroll processing