Medical Billing Expert
Location: Hayward, CA
Employment Type: Contract
Pay Range: $20-$24 per hour
Job Summary
The Medical Billing Expert is responsible for managing the medical billing process from claim creation through payment reconciliation. This role ensures accurate coding, timely claim submission, insurance verification, payment posting, denial management, and compliance with healthcare regulations. The ideal candidate has strong knowledge of medical billing practices, insurance guidelines, and revenue cycle management while maintaining excellent attention to detail and customer service.
Key Responsibilities
- Prepare, review, and submit accurate medical claims to insurance carriers.
- Verify patient insurance eligibility and benefits.
- Process electronic and paper claims in a timely manner.
- Monitor claim status and follow up on unpaid or denied claims.
- Investigate and resolve billing discrepancies, claim rejections, and payment issues.
- Post insurance and patient payments accurately.
- Manage accounts receivable and work aging reports to reduce outstanding balances.
- Communicate with insurance companies regarding claim status, authorizations, and appeals.
- Respond to patient billing inquiries professionally and accurately.
- Maintain compliance with HIPAA, Medicare, Medicaid, and commercial payer regulations.
- Ensure accurate documentation and maintain billing records.
- Collaborate with providers, coders, and administrative staff to resolve billing issues.
- Generate billing and financial reports as requested.
- Stay current on payer policies, coding updates, and industry regulations.
Required Qualifications
- High school diploma or equivalent; associate degree or certification preferred.
- 2+ years of experience in medical billing, healthcare revenue cycle, or related field.
- Strong understanding of medical terminology, CPT, ICD-10, and HCPCS coding systems.
- Knowledge of insurance claims processing, reimbursement methodologies, and payer requirements.
- Experience with Electronic Health Record (EHR) and Practice Management (PM) systems.
- Proficiency in Microsoft Office, particularly Excel.
- Excellent analytical, organizational, and problem-solving skills.
- Strong verbal and written communication skills.
- High level of accuracy and attention to detail.
Preferred Qualifications
- Certified Professional Biller (CPB) or similar certification.
- Experience with Medicare, Medicaid, and commercial insurance billing.
- Knowledge of prior authorization and appeals processes.
- Experience with multi-specialty or high-volume medical practices.
Key Skills
- Medical billing and claims processing
- Revenue cycle management
- Insurance verification
- Denial management and appeals
- Payment posting and reconciliation
- Accounts receivable management
- Medical coding knowledge (CPT, ICD-10, HCPCS)
- HIPAA compliance
- Data entry and documentation
- Customer service
- Time management
- Problem-solving
- Attention to detail
Working Conditions
- Office or remote work environment, depending on organizational needs.
- Standard business hours with occasional overtime during peak billing cycles.
- Prolonged periods of sitting and computer use.