Position Summary

We are seeking an experienced Medical Biller/Collector to join our busy specialty medical practice in Pasadena. The ideal candidate will be responsible for managing the full revenue cycle process, including insurance claim submission, payment posting, collections, benefits verification, and account follow-up. This role requires strong knowledge of medical billing procedures, insurance reimbursement practices, and the ability to thrive in a fast-paced healthcare environment.

Key Responsibilities

• Prepare, review, and submit insurance claims accurately and timely to commercial and government payers.
• Follow up on unpaid, denied, or underpaid claims to ensure maximum reimbursement.
• Manage patient and insurance collections, including outstanding account balances.
• Verify patient insurance eligibility, benefits, authorizations, and coverage details.
• Post insurance and patient payments accurately and reconcile accounts as needed.
• Investigate and resolve billing discrepancies, claim rejections, and payment variances.
• Work with PPO, HMO, and other insurance plans to ensure proper claims processing and reimbursement.
• Communicate with insurance companies, patients, and internal staff regarding billing inquiries.
• Maintain detailed documentation of account activity and collection efforts.
• Ensure compliance with HIPAA regulations and company billing policies.

Qualifications

• Minimum 2+ years of medical billing and collections experience in a physician practice, specialty clinic, or healthcare setting.
• Strong knowledge of PPO, HMO, and managed care insurance plans.
• Experience with insurance claims follow-up, appeals, and reimbursement processes.
• Understanding of medical collections and accounts receivable management.
• Basic knowledge of ICD-10, CPT, and HCPCS coding.
• Proficiency with EMR/EHR and medical billing software systems.
• Strong attention to detail, organizational, and problem-solving skills.
• Excellent communication and customer service abilities.
• Ability to prioritize workload and work effectively in a fast-paced environment.

Preferred Qualifications

• Experience in a specialty medical practice.
• Knowledge of revenue cycle management and healthcare billing regulations.
• Bilingual (English/Spanish) is a plus.