JOB DESCRIPTION

Position: Medical Biller / Accounts Receivable (AR) Specialist

Pay Range: $27.00-$30.00 PER HR

Reporting To: Reimbursement Manager

Work Type: On-Site

POSITION SUMMARY:

The Medical Biller / AR Specialist Must have strong revenue cycle experience, including hands on work with CalAIM (Medi Cal managed care). The Medical Biller/ AR Specialist will own end to end billing, follow ups, denials management, and AR resolution to drive clean claims and steady cash flow.

REQUIRED QUALIFICATIONS:

1. High school diploma or GED preferred.
2. 3+ years of medical billing/AR follow up experience in a healthcare setting.
3. Proven proficiency with Medi Cal managed care and commercial payers� claim workflows.
4. Track record resolving denials, submitting appeals, and obtaining/correcting authorizations.
5. Proficiency with EMR/EHR and billing systems; strong Excel skills (filters, sorting, lookups).
6. Exceptional attention to detail, organization, and written communication.

PREFFERED QUALIFICATIONS:

1. Direct CalAIM experience (e.g., ECM/CS or other CalAIM benefits), MCP portal submissions, and authorization management.
2. Home health, or community-based services billing background.

ESSNENTIAL DUTIES AND RESPONSIBILITIES:

The following is a representation of the major duties and responsibilities of this position. The agency will make reasonable accommodations to allow otherwise qualified applicants with disabilities to perform essential functions.

1. Prepare, review, and submit clean claims to Medi Cal, commercial payers, and managed care plans.
2. CalAIM: submit and track claims to MCPs, verify authorizations, resolve denials tied to medical necessity, prior auth, referrals, and program eligibility; prepare professional appeal letters and retro-auth requests when applicable.
3. Perform accurate charge entry, payment posting, and adjustments; reconcile remittances (ERA/EOB) and maintain precise documentation in EMR/billing systems.
4. Work AR aging by payer and by program); identify denial patterns and escalate root causes with clear summaries.
5. Answer billing inquiries from patients, providers, and MCPs with professional, timely communication.

PHYSICAL REQUIREMENTS:

• Stand, sit, talk, hear, reach, stoop, kneel and use of hands and fingers to operate computer, telephone, and keyboard on a frequent basis (up to 75% of the time).
• Close vision requirements due to computer work.
• Light to moderate lifting may be required (up to 25lbs).