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WorkNest Solutions

Medical Billing

Career Insights for Medical Claims Processor / Representative

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What they do

A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.

$47,705 / year median in California

-9% projected decline

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Job Description

Medical Billing WorkNest Solutions Sacramento, CA Job Details Full-time $23.69 - $30.94 an hour 1 hour ago Benefits Health insurance Dental insurance Paid time off Vision insurance Qualifications Customer communication Medical office experience Medical administrative support Attention to detail Medical billing Medical billing specialist experience Individual consumer customer service Productivity software Medical terminology Full Job Description Overview Join our dynamic healthcare team as a Medical Billing Specialist and play a vital role in ensuring accurate and efficient processing of medical claims and patient billing. In this energetic position, you will manage the entire billing cycle, from verifying insurance details to submitting claims and following up on outstanding balances. Your expertise will directly contribute to the smooth financial operations of healthcare providers, helping patients receive the care they need while maintaining compliance with industry standards. We are looking for motivated individuals who thrive in a fast-paced environment and are passionate about delivering exceptional customer service. Responsibilities Prepare and submit accurate medical claims using billing software, ensuring compliance with healthcare regulations such as
ICD-10, CPT
coding, DRG, and ICD coding standards. Review patient records and medical documentation to ensure proper coding accuracy for diagnoses (ICD-9, ICD-10) and procedures (CPT). Follow up on unpaid or denied claims by communicating with insurance companies and patients to resolve discrepancies. Maintain detailed records of billing transactions, medical records, and correspondence related to healthcare claims management. Assist patients with billing inquiries, explaining charges clearly and providing excellent customer service throughout the process. Utilize EMR (Electronic Medical Records) and EHR (Electronic Health Records) systems to access patient information efficiently. Stay updated on health insurance policies, medical terminology, and industry best practices to ensure compliance and accuracy. Qualifications Proven experience in medical billing or medical office administration with familiarity in healthcare claims management. Strong knowledge of medical coding systems including
ICD-10, ICD-9, CPT
coding, DRG classifications, and ICD coding standards. Proficiency in Microsoft Office applications and billing software platforms used in healthcare settings. Experience working with EMR/EHR systems for managing medical records and documentation. Excellent understanding of health insurance processes, including verification, pre-authorizations, and claims submission. Exceptional attention to detail with the ability to interpret complex medical records accurately. Strong communication skills combined with a customer-focused approach to resolving billing issues efficiently. Join us as a Medical Billing Specialist and become an essential part of delivering seamless healthcare financial services! Your dedication will help improve patient experiences while supporting our mission to provide quality care through precise billing practices.
Pay:
$23.69 - $30.94 per hour Expected hours: 40.0 per week
Benefits:
Dental insurance Health insurance Paid time off Vision insurance
Experience:
Medical billing: 2 years (Required)
Work Location:
In person