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Our nonprofit client is seeking a Medical Billing Specialist to manage medical billing and health information functions related to program-based healthcare and support services. This role is responsible for accurate and timely claims submission, compliance with public and private payer requirements, and maintaining high-quality documentation that supports program operations and financial sustainability. The position requires strong attention to detail, confidentiality, and collaboration with program and administrative staff.
Job Responsibility
Prepare, submit, and track electronic and paper claims to public and private payers, ensuring accurate coding and required documentation
Monitor claim status, resolve denials and underpayments, and resubmit corrected claims as needed
Post payments and adjustments, reconcile remittance advice, and maintain accurate billing records
Review service notes and encounter documentation for completeness, clarity, and compliance with payer and program standards
Communicate with program and administrative staff regarding documentation requirements, billing timelines, and follow-up items
Maintain organized and secure electronic records in billing, EHR, and related systems
Assist with internal billing audits, quality assurance initiatives, and preparation for external monitoring or reviews
Ensure billing practices align with payer, contract, and regulatory requirements, including timely filing limits
Support preparation of reports related to service utilization, revenue, and billing activity
Protect all client information in accordance with HIPAA and applicable privacy regulations
Participate in staff meetings, trainings, and team discussions as needed
Perform other related duties as assigned
Requirements
Associate’s degree in Health Information Technology, Healthcare Administration, Billing/Coding, or a related field
or equivalent combination of education and directly related experience
At least 2 years of experience in medical billing, preferably including Medicaid/Medi-Cal or other public payer billing
Working knowledge of standard billing practices, including CPT/HCPCS and ICD-10 coding
Ability to read and interpret payer bulletins, remittance advice, and denial codes
High level of accuracy, attention to detail, and follow-through
Strong organizational and time-management skills with the ability to manage multiple priorities and deadlines
Clear written and verbal communication skills with clinical and non-clinical staff
Ability to work independently and collaboratively in a team-oriented environment
Proficiency with Microsoft Office or Google Workspace, including word processing, spreadsheets, email, and shared drives
Nice to have
Demonstrated experience in medical billing and collections
Familiarity with billing practices for commercial insurance plans and state-sponsored healthcare programs
Ability to perform detailed work accurately, efficiently, and with minimal supervision
Proficiency with computerized billing systems and basic accounting-related processes
Strong problem-solving skills with the ability to analyze account issues and determine appropriate next steps
Effective written and verbal communication skills for interacting with payers and internal stakeholders
Experience with behavioral health or care management billing
Experience working in nonprofit, community-based, or human services settings
Experience supporting data needs for case management or service tracking systems
Bilingual English/Spanish preferred but not required
Commitment to a mission-driven, service-oriented environment
Respectful, trauma-informed, and culturally responsive interactions with clients and staff
Strong professional boundaries and strict confidentiality
Reliability in attendance, documentation, and task completion
Flexibility and willingness to adapt to changing billing rules, systems, and program needs