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Medical Billing And Collections Jobs in Riverside, CA

UHS

Accounts Receivable Specialist - Full Time

Riverside, CA · On-site

$24 - $31.50/hr

Two years prior experience in medical billing/collections is REQUIRED. CERTIFICATES, LICENSES, AND REGISTRATIONS: None. ESSENTIAL FUNCTIONS: Essential functions are those tasks, duties and ...

UHS

Accounts Receivable Specialist - Full Time

Riverside, CA · On-site

$24 - $31.50/hr

Two years prior experience in medical billing/collections is REQUIRED. CERTIFICATES, LICENSES, AND REGISTRATIONS: None. ESSENTIAL FUNCTIONS: Essential functions are those tasks, duties and ...

UHS

Accounts Receivable Specialist - Full Time

Riverside, CA · On-site

$24 - $31.50/hr

Two years prior experience in medical billing/collections is REQUIRED. CERTIFICATES, LICENSES, AND REGISTRATIONS: None. ESSENTIAL FUNCTIONS: Essential functions are those tasks, duties and ...

UHS

Accounts Receivable Specialist - Full Time

Riverside, CA · On-site

$24 - $31.50/hr

Two years prior experience in medical billing/collections is REQUIRED. CERTIFICATES, LICENSES, AND REGISTRATIONS: None. ESSENTIAL FUNCTIONS: Essential functions are those tasks, duties and ...

PrideStaff

Accounting Specialist

Mission Viejo, CA · On-site

$70K - $75K/yr

... Billing, Collections, Account Reconciliations, and Financial Reporting . This position plays a key ... Experience in a high-growth, distribution, manufacturing, healthcare, medical device, or consumer ...

Posted today

Oso Home Care

Reimbursement Specialist

Irvine, CA · On-site

$25 - $31/hr

Minimum of 2 years of medical billing or collections experience in Home Infusion, Specialty Pharmacy, Home Health, or Infusion Services. * Experience with CPR+ (Mediware), CareTend, or similar health ...

Oso Home Care

Reimbursement Specialist

Irvine, CA · On-site

$25 - $31/hr

Minimum of 2 years of medical billing or collections experience in Home Infusion, Specialty Pharmacy, Home Health, or Infusion Services. * Experience with CPR+ (Mediware), CareTend, or similar health ...

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Medical Billing And Collections information

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How much do medical billing and collections jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for medical billing and collections 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.

Is it hard to get a job as a medical billing and collections specialist?

Getting a job as a medical billing and collections specialist typically requires relevant training or certification, familiarity with billing software, and attention to detail. While competition exists, having strong organizational skills and understanding healthcare policies can improve employment prospects.

What is the difference between Medical Billing And Collections vs Medical Coding?

AspectMedical Billing And CollectionsMedical Coding
Primary FocusSubmitting claims, managing payments, and collecting overdue balancesTranslating medical procedures into standardized codes for billing
CredentialsCertification in billing or coding, often CPC or similarCertification in coding, such as CPC or CCS
Work EnvironmentHealthcare offices, billing companies, hospitalsHealthcare facilities, coding services, insurance companies
Industry UsageUsed in revenue cycle management, patient billingUsed in documentation, claims processing, compliance

While both roles are essential in healthcare revenue management, Medical Billing And Collections focuses on submitting claims and collecting payments, whereas Medical Coding involves translating medical services into codes for billing and documentation. Understanding these differences helps clarify career paths and employer expectations in healthcare finance.

What are the most commonly searched types of Medical Billing And Collections jobs in Riverside, CA?

The most popular types of Medical Billing And Collections jobs in Riverside, CA are:

What cities near Riverside, CA are hiring for Medical Billing And Collections jobs?

Cities near Riverside, CA with the most Medical Billing And Collections job openings:

Medical Billing And Collections jobs near you
Infographic showing various Medical Billing And Collections job openings in Riverside, CA as of August 2026, with employment types broken down into 92% Full Time, 4% Part Time, and 4% Contract. Highlights an 100% In-person job distribution, with an average salary of $44,519 per year, or $21.4 per hour.

Billing and Credentialing Specialist

Clinivoy LLC

Irvine, CA

$23 - $28/hr

Full-time

Re-posted 22 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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