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Entry Level Medical Billing & Coding Jobs in Riverside, CA

Medix

Biller

Irvine, CA · On-site

$25 - $27/hr

PBM billing (not major medical) * Working with extremely high-volume claims * Claim adjudication * Handling authorizations * Reviewing medical records for prior authorization * Collecting co-pays

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Entry Level Medical Billing Coding information

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$13

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$28

How much do entry level medical billing & coding jobs pay per hour?

As of Jun 1, 2026, the average hourly pay for entry level medical billing & coding in Riverside, CA is $21.40, according to ZipRecruiter salary data. Most workers in this role earn between $18.32 and $23.56 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as an Entry Level Medical Billing & Coding Specialist, and why are they important?

To thrive as an Entry Level Medical Billing & Coding Specialist, you need a solid understanding of medical terminology, healthcare billing procedures, and coding systems such as ICD-10 and CPT, typically acquired through a certificate program or associate degree. Familiarity with medical billing software, electronic health records (EHR) systems, and certification such as Certified Professional Coder (CPC) are highly valued. Attention to detail, organizational skills, and effective communication are crucial soft skills for this role. These competencies ensure accurate billing, minimize claim denials, and support efficient revenue cycle management in healthcare organizations.

What are some common challenges faced by entry-level medical billing and coding professionals, and how can they be overcome?

Entry-level medical billing and coding professionals often encounter challenges such as understanding evolving insurance regulations, keeping up with frequent coding updates, and managing high volumes of medical records with accuracy. To overcome these hurdles, it's important to regularly attend training opportunities, utilize reference materials, and ask experienced colleagues for guidance. Developing strong attention to detail and organizational skills will also help ensure efficiency and reduce errors in claim submissions.

What are entry level medical billing and coding jobs?

Entry level medical billing and coding jobs involve processing healthcare claims, managing patient records, and ensuring accurate coding for medical procedures and diagnoses. These professionals work closely with healthcare providers and insurance companies to facilitate billing and reimbursement. Entry level roles typically require knowledge of medical terminology, coding systems like ICD-10 and CPT, and attention to detail. Many positions only require a certificate or associate degree, making them accessible for those new to the healthcare field.

What is the difference between Entry Level Medical Billing & Coding vs Medical Coding Specialist?

AspectEntry Level Medical Billing & CodingMedical Coding Specialist
CertificationsBasic coding and billing certifications (e.g., CPC, CCMA)Advanced coding certifications (e.g., CPC, CCS)
Work EnvironmentPhysician offices, hospitals, clinicsHospitals, insurance companies, healthcare facilities
Job FocusEntering billing data, coding diagnoses and procedures, submitting claimsReviewing and assigning accurate medical codes, ensuring compliance
Search IntentEntry level billing and coding jobs, beginner coding rolesSpecialized coding roles, advanced coding positions

Entry Level Medical Billing & Coding involves basic coding and billing tasks suitable for beginners, often requiring foundational certifications. Medical Coding Specialist roles typically demand more advanced coding skills and certifications, focusing on accurate code assignment and compliance. Both roles are essential in healthcare billing but differ in complexity and specialization.

What are the most commonly searched types of Medical Billing & Coding jobs in Riverside, CA? The most popular types of Medical Billing & Coding jobs in Riverside, CA are:
What are popular job titles related to Entry Level Medical Billing & Coding jobs in Riverside, CA? For Entry Level Medical Billing & Coding jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Entry Level Medical Billing & Coding jobs in Riverside, CA look for? The top searched job categories for Entry Level Medical Billing & Coding jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Entry Level Medical Billing & Coding jobs? Cities near Riverside, CA with the most Entry Level Medical Billing & Coding job openings:
Entry Level Medical Billing Coding jobs near you

Billing and Credentialing Specialist

Clinivoy LLC

Irvine, CA

$23 - $28/hr

Full-time

Posted 6 days ago

Job description

Profile Summary:

The Billing & Credentialing Specialist is responsible for managing the full revenue cycle for infusion services, including benefits investigation, verification, accurate claim submission, denial resolution, and AR follow-up. This role handles complex buy-and-bill infusion billing, including J-codes, S-codes, NDC crosswalks, biologics, and time-based infusion services. 

Additionally, the specialist manages provider credentialing and enrollment with Medicare, Medi-Cal, and commercial payers, ensuring compliance and timely activation. The position supports patients, providers, and internal departments to optimize reimbursement and maintain continuity of care.

Key Accountabilities: 

Medical Benefits Billing & Revenue Cycle Management 

  1. Verify medical benefits for infusion services, including specialty biologics, IVIG, and injectable therapies. 

  1. Complete detailed benefit investigation (BI) for medical benefits, deductible, OOP, copay, and coverage limitations. 

  1. Process, correct, and submit claims using CMS-1500 and UB-04 forms for facility and professional billing. 

  1. Apply proper coding for infusion services including: 

  • J-codes / S-codes 

  • NDC conversions & crosswalks 

  • Infusion CPT codes (96365-96379, 96401-96417) 

  • Modifier accuracy (JW, JG, 59, 25, etc.) 

  1. Manage buy-and-bill billing including ASP pricing, wastage documentation, and payer-specific requirements. 

  1. Monitor claim status and process secondary or tertiary claims as required. 

  1. Perform comprehensive AR collections, including tracking outstanding balances and resolving unpaid or underpaid claims. 

  1. Research and resolve claim errors, coding issues, and payer-specific infusion policies. 

  1. Manage prior authorization follow-up with the PA team and ensure claims are billed compliant with authorization terms. 

  1. Communicate with payers to resolve rejections, eligibility discrepancies, and coverage issues. 

Denials, Appeals & Reconsiderations 

  1. Review, analyze, and resolve claim denials related to medical necessity, coding, benefit coverage, or documentation. 

  1. Prepare and submit appeal packets including clinical justifications, medical records, infusion notes, and prior authorization details. 

  1. Draft high-quality appeal letters based on denial category and payer requirements. 

  1. Track appeal turnaround times and follow up with payers until resolution. 

  1. Coordinate with prescribers to obtain clinical notes, labs, and additional documents required for approvals or appeals. 

Provider Credentialing & Payer Enrollments 

  1. Complete credentialing and enrollment for providers with Medicare, Medi-Cal, and commercial insurance plans. 

  1. Maintain and update CAQH, NPPES, PECOS, and payer portal information. 

  1. Initiate and manage re-credentialing processes and track expiring documents. 

  1. Maintain an organized, compliant credentialing database. 

  1. Communicate with insurers and internal teams to ensure timely activation of provider billing privileges.

Division team/specific Accountabilities:  

  1. Communicate with patients to gather information required for benefits verification, billing setup, financial counseling, and to ensure accurate processing of infusion orders and authorizations. Build clear, supportive communication that promotes trust and patient loyalty. 

  1. Investigate and verify medical benefits for infusion and specialty biologic services, including deductible, co-pay, out-of-pocket costs, prior authorization requirements, site-of-care restrictions, step therapy, and medical policy guidelines. 

  1. Coordinate with manufacturer financial assistance programs, copay foundations, and internal support teams to help eligible patients obtain financial support, copay cards, or patient-assistance funding when appropriate. 

  1. Work closely with the Prior Authorization team by providing all required clinical and documentation updates, ensuring timely submission, tracking authorization progress, and maintaining consistent communication with the patient and provider. 

  1. Facilitate denial and appeal processes by requesting denial documentation, gathering clinical records, and preparing appeal packets. Compose appeal letters based on denial reason, medical necessity, and the patient's clinical condition. 

  1. Conduct regular status checks with insurance companies on pending authorizations, appeals, and claim adjudications. Obtain approval information, document outcomes, and update copay or financial assistance statuses when required. 

  1. Identify, track, and escalate service-delaying issues related to prior authorizations, benefit determinations, clinical documentation, or financial assistance gaps to ensure uninterrupted patient therapy and timely infusion scheduling. 

  1. Build and maintain effective working relationships with prescriber offices, referral partners, and clinical staff treating assigned disease states. Provide ongoing updates regarding case status, authorizations, and payer requirements. 

  1. Complete all required assessments or checklists mandated by manufacturer programs, payer requirements, or internal workflow processes to ensure compliance with program standards. 

  1. Review and respond to notifications of patients who require financial assistance, providing them with available program options, community resources, and support to help minimize out-of-pocket burden. 

  1. Assist patients with submitting financial assistance applications, including obtaining consent forms, uploading documentation, completing electronic applications, and following up with financial assistance programs to prevent therapy interruptions. 

  1. Maintain timely updates on pending or unfilled infusion orders, keeping prescription and authorization statuses current in the system at least every 48 hours or per department protocol. 

  1. Ensure that all activities comply with organizational standards, payer guidelines, manufacturer program requirements, and HIPAA. Deliver service in a manner that meets the highest standards of quality, accuracy, and patient care. 

Experience:

  • A minimum of 2 years of prior experience in a medical records department or like setting preferred.  

  • Prior experience with an Infusion clinic. (preferred) 

  • Dealing with third party billers. (preferred)

Behavioral Competencies:

  • Excellent verbal and written communication skills.   

  • Excellent interpersonal, negotiation, and conflict resolution skills.  

  • Excellent organizational skills and attention to detail.  

  • Strong analytical and problem-solving skills.  

  • Ability to prioritize tasks and to delegate them when appropriate.  

  • Ability to act with integrity, professionalism, and confidentiality.

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