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Medical Insurance Billing Coding Jobs in Riverside, CA

Star Smile Dental

Dental Treatment Coordinator

Anaheim, CA · On-site

$25 - $30/hr

  • Dental

  • PTO

Billing & Coding: Manage medical billing, Medicare/Medicaid compliance, and medical collection efforts using ICD-9/10 and CPT codes. Complex Coordination: Handle insurance verification for outpatient ...

Star Smile Dental

Dental Treatment Coordinator

Anaheim, CA · On-site

$25 - $30/hr

  • Dental

  • PTO

Billing & Coding: Manage medical billing, Medicare/Medicaid compliance, and medical collection efforts using ICD-9/10 and CPT codes. Complex Coordination: Handle insurance verification for outpatient ...

MARC H SHOMER MD PHD INC

Medical Biller Specialist

Upland, CA · On-site

$18 - $24/hr

  • Medical

  • Dental

  • Life

  • Retirement

Knowledge of ICD-10 and CPT Codes * Proficient with Excell * Responsible and Reliable ... Contacting Insurance Companies * ​Submitting Authorizations * Answering Phone Calls * Submitting ...

MARC H SHOMER MD PHD INC

Medical Biller Specialist

Upland, CA · On-site

$18 - $24/hr

  • Medical

  • Dental

  • Life

  • Retirement

Knowledge of ICD-10 and CPT Codes * Proficient with Excell * Responsible and Reliable ... Contacting Insurance Companies * ​Submitting Authorizations * Answering Phone Calls * Submitting ...

LSMA Management Inc

Claims Examiner

San Bernardino, CA · On-site

$28.85 - $33.65/hr

This role applies plan and contract rules, reimbursement methodologies, and medical billing/coding guidelines to ensure claims are processed accurately, timely, and in compliance with federal and ...

LSMA Management Inc

Claims Examiner

San Bernardino, CA · On-site

$28.85 - $33.65/hr

This role applies plan and contract rules, reimbursement methodologies, and medical billing/coding guidelines to ensure claims are processed accurately, timely, and in compliance with federal and ...

Concentra

Medical Billing Specialist

Rancho Cucamonga, CA · On-site

$23 - $25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... billing and reconciliation of discrepancies in accordance with Concentra Medical Compliance ... Life Insurance/Disability * Paid Time Off * Colleague Referral Bonus Program This position is ...

Concentra

Medical Billing Specialist

Rancho Cucamonga, CA

$23 - $25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... billing and reconciliation of discrepancies in accordance with Concentra Medical Compliance ... Life Insurance/Disability * Paid Time Off * Colleague Referral Bonus Program This position is ...

Concentra

Medical Billing Specialist

Rancho Cucamonga, CA · On-site

$23 - $25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... billing and reconciliation of discrepancies in accordance with Concentra Medical Compliance ... Life Insurance/Disability * Paid Time Off * Colleague Referral Bonus Program This position is ...

Concentra

Medical Billing Specialist

Rancho Cucamonga, CA

$23 - $25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... billing and reconciliation of discrepancies in accordance with Concentra Medical Compliance ... Life Insurance/Disability * Paid Time Off * Colleague Referral Bonus Program This position is ...

LSMA Management Inc

Claims Examiner

San Bernardino, CA · On-site

$28.85 - $33.65/hr

This role applies plan and contract rules, reimbursement methodologies, and medical billing/coding guidelines to ensure claims are processed accurately, timely, and in compliance with federal and ...

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All JobsMedical Insurance Billing Coding JobsMedical Insurance Billing Coding Jobs in Riverside, CA

Medical Insurance Billing Coding information

See Riverside, CA salary details

$14

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$30

How much do medical insurance billing coding jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for medical insurance billing coding in Riverside, CA is $22.91, according to ZipRecruiter salary data. Most workers in this role earn between $18.80 and $24.09 per hour, depending on experience, location, and employer.

What is medical insurance billing and coding?

Medical insurance billing and coding is the process of translating healthcare services, treatments, and diagnoses into standardized codes that are used for billing purposes. Medical coders review clinical documentation and assign appropriate codes, while billers use these codes to prepare and submit insurance claims for reimbursement. This ensures that healthcare providers are paid correctly and that claims comply with regulations and insurance requirements. The work requires attention to detail, knowledge of medical terminology, and familiarity with coding systems like ICD-10, CPT, and HCPCS.

What are the key skills and qualifications needed to thrive as a medical insurance billing and coding specialist?

To thrive as a Medical Insurance Billing and Coding Specialist, you need a strong understanding of medical terminology, anatomy, coding systems (such as ICD-10, CPT, and HCPCS), and typically a certification like CPC or CCS. Familiarity with billing software, electronic health records (EHRs), and claims management platforms is essential. Attention to detail, integrity, and strong organizational and communication skills set top performers apart in this role. These competencies are crucial to ensure accurate claim submissions, reduce errors, and facilitate smooth reimbursement processes for healthcare providers.

What are some common challenges faced by medical insurance billing and coding professionals, and how can they be managed?

Medical Insurance Billing and Coding professionals often encounter challenges such as keeping up with constantly changing insurance regulations, accurately interpreting complex medical codes, and minimizing claim denials or rejections. Staying current with industry updates through continuous education and certification renewals is essential. Effective communication with healthcare providers and insurance representatives, as well as attention to detail and strong organizational skills, help manage workload and ensure accurate, timely claim submissions.

What is the difference between Medical Insurance Billing Coding vs Medical Claims Specialist?

AspectMedical Insurance Billing CodingMedical Claims Specialist
CertificationsCertified Professional Coder (CPC), Certified Coding Associate (CCA)Typically similar certifications, may include claims processing certifications
Work EnvironmentHospitals, clinics, insurance companiesInsurance companies, healthcare providers, billing offices
Job FocusAssigning codes to diagnoses and procedures for billingProcessing, reviewing, and managing insurance claims
Common Search IntentUnderstanding coding roles, certification requirementsClaims processing, reimbursement procedures

Both roles involve working with healthcare documentation and insurance processes. Medical Insurance Billing Coding focuses on assigning accurate codes for billing, while Medical Claims Specialists handle the submission and management of insurance claims. They often work together but have distinct responsibilities within the healthcare revenue cycle.

Is a job in medical insurance billing coding worth it?

Medical insurance billing and coding is a stable healthcare job that involves translating medical procedures into standardized codes for billing purposes. It typically requires certification, such as CPC or CCS, and offers opportunities for remote work and career advancement. The role provides steady employment with moderate entry requirements and a growing demand due to healthcare industry expansion.

Is it hard to get a job as a medical insurance billing coding specialist?

Getting a job as a medical insurance billing and coding specialist can vary depending on location and experience, but generally, the field has steady demand due to the need for accurate medical record management. Certification and familiarity with coding systems like ICD-10 and CPT can improve job prospects, and many roles offer flexible schedules. Entry-level positions are often available for those with relevant training or certification programs.

What are popular job titles related to Medical Insurance Billing Coding jobs in Riverside, CA?

For Medical Insurance Billing Coding jobs in Riverside, CA, the most frequently searched job titles are:

What job categories do people searching Medical Insurance Billing Coding jobs in Riverside, CA look for?

The top searched job categories for Medical Insurance Billing Coding jobs in Riverside, CA are:

What cities near Riverside, CA are hiring for Medical Insurance Billing Coding jobs?

Cities near Riverside, CA with the most Medical Insurance Billing Coding job openings:

Medical Insurance Billing Coding jobs near you
Infographic showing various Medical Insurance Billing Coding job openings in Riverside, CA as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 16% Part Time, and 6% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $47,648 per year, or $22.9 per hour.

Billing and Credentialing Specialist

Clinivoy LLC

Irvine, CA

$23 - $28/hr

Full-time

Re-posted 25 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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