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Administrative
Medical Biller
Anaheim, CA

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Novo Behavioral Services

Medical Claims Biller ABA / Behavioral Health

Job Description

Position Summary Novo is seeking a detail-oriented and experienced Medical Claims Biller to support our billing and revenue cycle operations. The ideal candidate will have experience with ABA (Applied Behavior Analysis), behavioral health, or medical billing and will be comfortable managing claims from initial submission through payment and reconciliation. Experience using CentralReach is strongly preferred. This position requires someone who can independently identify billing issues, research unpaid or denied claims, make necessary corrections, interpret EOBs/ERAs, reconcile payments, and follow claims through to resolution. The successful candidate will be highly organized, accurate, analytical, and proactive in identifying issues that could delay or reduce reimbursement. Key ResponsibilitiesClaims Billing & Submission Prepare, review, and submit accurate insurance claims to commercial and government payers. Verify that claims contain the correct service codes, modifiers, units, dates of service, provider information, authorizations, and payer information. Review claims for accuracy and completeness prior to submission. Submit corrected claims, replacement claims, and reconsiderations as necessary. Monitor clearinghouse and payer rejections and resolve issues promptly. Track claims from submission through final payment or resolution. Denials & Accounts Receivable Follow-Up Research unpaid, underpaid, rejected, and denied claims. Identify the root cause of claim denials and make the appropriate corrections. Resubmit corrected claims and supporting documentation within payer filing deadlines. Contact insurance companies and use payer portals to obtain claim status and resolve outstanding balances. Escalate recurring payer, authorization, coding, or documentation issues to management. Maintain organized follow-up notes and documentation regarding outstanding claims. Payment Posting & Reconciliation Review and interpret EOBs (Explanation of Benefits) and ERAs (Electronic Remittance Advice). Reconcile insurance payments against submitted claims and expected reimbursement. Identify underpayments, overpayments, payment discrepancies, recoupments, and adjustments. Research discrepancies between billed charges, contracted rates, payments, and outstanding balances. Assist with month-end accounts receivable and billing reconciliation. Ensure payments and adjustments are accurately reflected within the billing system. Invoicing Prepare and send invoices as required. Monitor outstanding invoices and follow up on unpaid balances. Ensure invoices accurately reflect services rendered, payments received, adjustments, and balances due. Maintain accurate supporting documentation for invoiced services. ABA / Behavioral Health Billing Review ABA and behavioral health claims for appropriate service codes, modifiers, units, authorizations, and rendering providers. Understand the relationship between clinical documentation, authorizations, scheduled services, rendered services, and billing. Identify authorization or utilization issues that could prevent reimbursement. Work with clinical, scheduling, authorization, and administrative teams to resolve billing discrepancies. CentralReach Candidates with CentralReach experience are strongly preferred.
Responsibilities may include:
Reviewing appointments and converting completed services into billable claims. Reviewing billing entries for accuracy. Identifying missing or incorrect information affecting claim submission. Reviewing authorizations and utilization. Tracking claims and payments. Reconciling services, claims, and payments. Researching billing discrepancies within CentralReach. Generating billing and accounts receivable reports as needed. Required Qualifications Previous experience in medical claims billing, revenue cycle management, or accounts receivable. Experience reviewing and correcting rejected or denied insurance claims. Ability to read and interpret EOBs and ERAs. Experience reconciling claims and insurance payments. Knowledge of insurance claim submission and follow-up processes. Strong attention to detail and ability to identify financial discrepancies. Strong organizational and time-management skills. Ability to independently research and resolve billing issues. Comfortable working with payer portals, clearinghouses, billing systems, spreadsheets, and electronic records. Ability to maintain confidentiality and comply with HIPAA requirements. Strong written and verbal communication skills. Preferred Qualifications CentralReach experience strongly preferred. Previous ABA or behavioral health billing experience strongly preferred. Familiarity with common ABA procedure codes and modifiers. Experience working with commercial insurance, Medicaid, managed care plans, or regional health plans. Experience with authorization-based healthcare services. Experience identifying payer underpayments using contracted reimbursement rates. Experience with accounts receivable aging and denial management. Experience preparing invoices and performing payment reconciliation. Proficiency with Microsoft Excel or Google Sheets. Key Competencies The ideal candidate is: Detail-oriented and highly accurate. Persistent with claim follow-up and resolution. Comfortable investigating discrepancies. Able to manage a high volume of claims and competing priorities. Proactive rather than waiting for billing issues to escalate. Able to recognize patterns in denials and reimbursement problems. Financially minded and understands the importance of timely collections and accurate reimbursement. Comfortable communicating with insurance companies and internal clinical and administrative teams. Key Performance Expectations Performance in this position may be measured by: Clean claim submission rate. Timeliness of claim submission. Denial and rejection resolution time. Accounts receivable aging. Percentage of claims collected. Accuracy of payment posting and reconciliation. Timeliness of follow-up on unpaid claims. Recovery of underpaid or incorrectly processed claims. Accuracy and timeliness of invoicing. Documentation quality within billing and payer systems. Join our team to play a crucial role in supporting behavioral health providers by ensuring smooth billing operations. Your expertise will directly contribute to delivering quality care while fostering a positive experience for patients and their families. We value energetic professionals committed to accuracy, efficiency, and continuous learning in a fast-paced healthcare setting.
Pay:
$22.00 - $30.00 per hour Expected hours: 20.0 per week
Benefits:
401(k) Dental insurance Flexible schedule Health insurance Paid time off Retirement plan
Education:
Bachelor's (Preferred)
Experience:
Medical billing: 2 years (Required) Shift availability: Day Shift (Preferred) Ability to
Commute:
Anaheim, CA 92804 (Required)
Work Location:
Hybrid remote in Anaheim, CA 92804