Medical Billing Specialist

Summary

Join IntelliPro as a Senior Medical Billing Specialist in Sunnyvale, California, where you will manage medical billing and reimbursement processes, ensuring compliance with healthcare regulations and optimizing revenue capture.

Requirements

• Bachelor's degree in Accounting, Healthcare Administration, Finance, Business, or related field
• 2-5 years of experience in office or healthcare-related environments
• Knowledge of CPT/ICD-10/HCPCS codes and EHR systems
• Strong proficiency in medical terminology and insurance plans
• Experience with process improvement, quality control, and data analysis
• Strong attention to detail, confidentiality, and ability to work independently
• Excellent verbal and written communication, organizational, and time management skills
• Proficiency in Google Docs, Sheets, Slides, and Microsoft Office Suite

Responsibilities

• Verify patient benefits and insurance eligibility through insurance providers
• Manage the complete billing process (charge entry, claim submission, payment posting, and accounts receivable)
• Follow Medicare, state programs, and HMO/PPO regulations
• Handle claim resubmissions and appeals for payment
• Generate and analyze insurance reimbursement reports
• Identify trends, optimize revenue capture, and reduce revenue leakage
• Conduct audits to ensure accuracy and compliance with billing processes
• Process Improvement: Develop and implement departmental procedures to enhance billing efficiency
• Collaborate with IT to implement technology enhancements
• Conduct billing training and maintain documentation
• Liaise with insurance companies, medical groups, and internal teams to resolve outstanding claims, denials, and discrepancies
• Maintain organized documentation of billing activities, invoices, and payments

Benefits

Full-Time position