We are seeking a proactive and detail-oriented Reimbursement Specialist to join our healthcare team. In this vital role, you will be responsible for managing the reimbursement process for medical services, ensuring accurate and timely claims submissions, and optimizing revenue recovery. Your expertise will help streamline billing workflows, resolve claim denials, and support the overall financial health of our organization. If you thrive in a fast-paced environment and possess a passion for accurate medical coding and billing, this is an exciting opportunity to make a meaningful impact in patient care and organizational success.
Responsibilities include reviewing and interpreting medical records related to coding systems such as DRG, CPT, ICD-9, and ICD-10 to ensure billing accuracy; preparing and submitting claims via EMR/EHR systems according to payer guidelines; analyzing claim denials and implementing corrective actions; collaborating with healthcare providers to clarify documentation issues; monitoring accounts receivable and performing collections; maintaining detailed billing records; and staying current with medical billing regulations and coding standards.
Preferred experience includes medical billing, coding, or reimbursement in healthcare, strong familiarity with DRG, CPT, ICD-9/10 coding, medical terminology, EMR/EHR systems, insurance claims processing, and collections using payer portals such as Availity and Novologix. Effective communication and attention to detail are essential. Pharmacy/IVIG/Home Infusion Billing experience is preferred but not required.
Work is on-site in Orange, CA.
- Proven experience in medical billing, coding, or reimbursement roles within healthcare.
- Strong knowledge of DRG classifications, CPT coding, ICD-9/10 coding systems, and medical terminology.
- Familiarity with EMR/EHR systems used for billing and documentation.
- Experience with insurance claims processing, medical records management, and collections.
- Familiarity with payer portals such as Availity and Novologix.
- Attention to detail and ability to interpret complex medical documentation.
- Effective communication skills for collaboration with providers and payers.
- Pharmacy/IVIG/Home Infusion Billing experience preferred (1 year).
- 401(k) and 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Paid time off
- Referral program
- Vision insurance
Location
California, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
3 weeks ago