Medical Billing at STEPPING FORWARD COUNSELING CENTER LLC – Irvine, California

About the Role:

The Medical Billing professional plays a critical role in the healthcare revenue cycle by ensuring accurate and timely processing of patient billing information. This position involves managing insurance claims, verifying patient data, and collaborating with healthcare providers to resolve billing discrepancies. The primary goal is to maximize reimbursement for medical services while maintaining compliance with healthcare regulations and payer requirements. The role requires meticulous attention to detail and strong organizational skills to handle multiple accounts and billing cycles efficiently. Ultimately, the Medical Billing specialist contributes to the financial health of the healthcare organization by facilitating smooth and accurate billing operations.

Minimum Qualifications:

• High school diploma or equivalent required; associate degree or certification in medical billing or health information management preferred.
• Proven experience in medical billing or a related healthcare administrative role.
• Familiarity with medical billing software and electronic health record (EHR) systems.
• Strong understanding of medical terminology, billing codes (CPT, ICD-10, HCPCS), and insurance claim processes.
• Excellent communication and organizational skills.

Preferred Qualifications:

• Certification such as Certified Professional Biller (CPB) or Certified Coding Associate (CCA).
• Experience working with multiple insurance payers including Medicare and Medicaid.
• Knowledge of HIPAA regulations and healthcare compliance standards.
• Proficiency in advanced billing software and data analysis tools.
• Prior experience in a fast-paced medical office or hospital environment.

Responsibilities:

• Prepare and submit insurance claims accurately and promptly to various insurance companies and government programs.
• Review patient records and billing information to ensure completeness and accuracy before claim submission.
• Follow up on unpaid or denied claims by communicating with insurance companies and healthcare providers to resolve issues.
• Maintain up-to-date knowledge of billing codes, insurance policies, and healthcare regulations to ensure compliance.
• Generate billing reports and reconcile accounts to track payments, adjustments, and outstanding balances.

Skills:

The required skills enable the Medical Billing professional to accurately interpret medical records and apply appropriate billing codes, ensuring claims are submitted correctly to avoid delays or denials. Strong communication skills are essential for interacting with insurance companies, healthcare providers, and patients to clarify billing issues and resolve discrepancies. Organizational skills help manage multiple billing accounts and deadlines efficiently, maintaining smooth workflow. Preferred skills such as certification and advanced software proficiency enhance the ability to navigate complex billing systems and regulatory requirements. Together, these skills support the daily tasks of claim preparation, follow-up, and reporting, contributing to the financial stability of the healthcare organization.