Medical Biller

Agility Recruiting

Medical Biller

National
Full Time
Paid
  • Responsibilities

    Two openings: one ~2-month assignment, one ~6-month assignment Location: Fully remote Reports to: Billing Manager

    About the Role

    A nonprofit human services organization is seeking two temporary Medical Billing Specialists. The Billing Specialists will play a key role in ensuring accurate and timely processing of claims, eligibility verification, and reimbursement for services delivered to clients.

    Key Responsibilities

    • Enter service data into Alameda County's behavioral health EHR (SmartCare) and reconcile entries to ensure billing accuracy
    • Verify client eligibility through California's Medi-Cal provider portal and the commercial clearinghouse (Optum Revenue Performance Advisor)
    • Communicate eligibility changes, lapses, and coverage updates to the Quality Assurance team and direct care staff
    • Maintain and manage client records within SmartCare
    • Prepare, submit, and track insurance claims, including coding diagnoses and procedure codes
    • Monitor claims for timely submission; investigate and resolve billing inaccuracies
    • Bill and collect copays/deductibles from parents and guardians where applicable
    • Review billing denial queues and resubmit claims as needed
    • Reconcile payments, work with payers to appeal and correct errors, and resolve discrepancies
    • Maintain proper documentation for each claim, including approvals and denials
    • Stay current on changes in billing codes, regulations, and payer policies

    Qualifications

    • Education and experience: Bachelor's degree, OR Associate degree plus 1 year of relevant experience, OR high school diploma/GED plus 2 years of relevant experience
    • 1-2 years of experience in medical billing, data entry, claims processing, or revenue cycle billing
    • Familiarity with Medi-Cal and commercial insurance payors strongly preferred
    • Prior experience with SmartCare, Optum Revenue Performance Advisor, or similar EHR/clearinghouse systems is a plus
    • Some experience with accruals and AP/credit card reconciliation a plus
    • Strong Excel skills
    • Excellent organizational, analytical, and problem-solving abilities
    • Detail-oriented with proven ability to manage and track large volumes of information
    • Strong written and verbal communication skills
    • Must be at least 21 years of age
    • Ability to clear TB test, fingerprinting, and any other state/federal licensing requirements