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Job Description Established Medical Billing Company Seeking Experienced Professional We are a fast-paced, well-established medical billing company seeking an experienced Medical Biller / Data Entry Specialist to join our team. The ideal candidate already understands CPT and ICD-10 coding and is comfortable working independently in a high-volume production environment. We are looking for someone seeking long-term stability and growth within a professional billing team. Key Responsibilities • Accurately enter CPT and ICD-10 procedure codes into billing software, • Manage high-volume data entry with precision and consistency, • Maintain compliance with medical coding guidelines and payer requirements, • Review and monitor coded entries for accuracy and completeness as part of routine workflow, • Collaborate with team members to identify discrepancies and improve overall billing accuracy Required Qualifications • Minimum 2 years of recent medical billing and coding experience, • Strong working knowledge of CPT and ICD-10 codes, • Proven experience handling high-volume data entry, • Excellent attention to detail and organizational skills, • Ability to work independently with minimal supervision Preferred Experience • Medisoft billing software, • Chiropractic billing What We Offer • Competitive hourly pay, • Health, dental, vision & life insurance, • 401(k) plan, • Paid vacation & sick time, • Stable Monday–Friday schedule, • Supportive, team-focused environment Schedule: • 8-hour shift, • Monday to Friday, • Occasional weekends as needed\nCompany Description ACM is a trusted, family-led medical billing company established in 1988, specializing in chiropractic billing with decades of expertise navigating complex insurance systems and maximizing provider revenue. ACM is a trusted, family-led medical billing company established in 1988, specializing in chiropractic billing with decades of expertise navigating complex insurance systems and maximizing provider revenue.

Job DescriptionDescription:We are hiring in the following states:AR, AZ, CA, CO, FL, GA, IA, IL, LA, MO, MT, NC, NE, NJ, NV, OK, PA, SD, TN, TX, VA, WA, and WIThis is a remote position.Overview:As a healthcare revenue cycle business, we manage insurance claims and oversee timely claim resolution and payment processing for our clients. This role involves overseeing and completing the administrative responsibilities of billing insurance, correcting rejections, resolving billing rejections, collaborating with client teams to ensure the financial success of the healthcare organizations we support. Duties & Responsibilities: • Prepare and submit billing data and medical claims (hospital and physician) to insurance companies in accordance with federal, state, and payer mandated guidelines., • Comply with productivity standards while maintaining quality levels., • Ensure proper hospital claim submission and payment through review and correction of claim edits, errors, and denials., • Investigate, follow up with payers, and work claims as assigned., • Perform posting billing adjustments., • Ensure billing reroutes are worked timely and comply with company procedures., • Conduct duties in a professional and timely fashion., • Achieve maximum reimbursement for services provided., • Punctual, dependable, and adapt easily to change., • Must complete payor specific rules and regulations training.Requirements: Requirements & Qualifications: • Experience with EPIC system preferred., • High school diploma or equivalent required, • Associate's degree preferred, • 2+ years of work experience as a Medical Biller or similar role., • Proficiency in Microsoft Office Suite, Teams, and virtual meeting platforms (GoToMeeting, Zoom)., • Proficiency with computers including Microsoft Office Suite/Teams, GoToMeeting/Zoom, etc. Knowledge, Skills & Abilities: • Knowledge of ICD-10 Diagnosis and procedure codes and CPT/HCPCS codes., • Knowledge of rules and regulations relative to medical billing practices and regulations., • Knowledge of revenue cycle data analysis and interpretation., • Skilled in medical accounts investigation., • Skilled in billing software and electronic medical records., • Skilled in analytical and critical thinking., • Skilled in professional writing and communication., • Skilled in time management and organization., • Ability to problem-solve and organize., • Ability to multitask and manage time effectively., • Ability to provide attention to detail. Disclosure Statement: As part of the Currance application and hiring experience, all candidates are subject to a criminal background check, employment verification check and a government exclusion check. The government exclusion check is a mandatory screening process that verifies whether an individual is listed on federal or state exclusion or watchlists, including but not limited to, the Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) and the System for Award Management (SAM.gov). These screenings are conducted to ensure compliance with applicable federal and state laws and regulations, to protect the integrity of federally funded programs, the clients we support, and to prevent participation by individuals who are excluded due to fraud, abuse, or other misconduct. By submitting an application, candidates acknowledge and consent to these checks as a condition of employment or engagement.

Job Description About AmeriPharma AmeriPharma is a rapidly growing healthcare company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity. We like people who are passionate about their roles and people who like to grow and change as the company evolves. AmeriPharma’s Benefits • Full benefits package including medical, dental, vision, life that fits your lifestyle and goals, • Great pay and general compensation structures, • Employee assistance program to assist with mental health, legal questions, financial counseling etc., • Comprehensive PTO and sick leave options, • 401k program, • Plenty of opportunities for growth and advancement, • Company sponsored outings and team-building events, • Casual Fridays Job Summary The Billing Administrator plays a vital role in supporting the financial operations of AmeriPharma® by ensuring the accuracy and efficiency of the billing and collections process. This position is responsible for a range of administrative and clerical tasks to assist with billing, cash posting, collections, and overall reimbursement activities. This role requires strong communication and time management skills, as well as the ability to work collaboratively with internal departments such as billing, collections, and reimbursement. The Billing Administrator will support day-to-day operations, assist in maintaining accurate financial records, and help ensure timely reimbursement from insurance payers and patients. Schedule Details • Location: On-Site, Laguna Hills, CA, • Hours: Monday to Friday, 8:00 AM to 4:30 PM Duties and Responsibilities • Retrieve and provide Explanation of Benefits (EOBs) to the cash posting team, • Sort incoming correspondence and route to the appropriate reimbursement specialist, • Scan and upload daily correspondence into designated folders, • Distribute incoming faxes to appropriate team members, • Support the unapplied cash reporting process, • Assist with patient balance adjustments and related account tasks, • Collaborate with the Lead Biller and Lead Collector to ensure workflows are followed accurately, • Enter and manage data using spreadsheets and Google Sheets, • Maintain and organize departmental documents and communications, • Assist in processing refund and overpayment requests, • Perform general clerical duties such as answering phones and preparing reports or internal documents, • Carry out other duties as assigned by management Required Qualifications • Ability to read, write, and speak fluent English, • Strong interpersonal and communication skills, • Excellent time management, prioritization, and multi-tasking abilities, • Ability to work independently and collaboratively in a fast-paced environment, • Strong analytical and problem-solving skills, • Proficiency with spreadsheets, document scanning, and online claim submission portals, • Ability to understand and interpret data, reports, and insurance documentation, • Attention to detail and ability to handle sensitive information with confidentiality Education and Experience Requirements • High School Diploma or equivalent, • 1–3 years of experience in billing, collections, clerical, or administrative support, • Knowledge of ICD-10, CPT, HCPCS codes, and the CMS HCFA 1500 form & electronic billing Preferred Qualifications • Billing certification or coursework, • Understanding of medical billing processes for both commercial and government insurance payers, • Prior experience with electronic billing systems and terminology used in specialty or infusion pharmacy is a plus AmeriPharma’s Mission Statement Our goal is to achieve superior clinical and economic outcomes while maintaining the utmost compassion and care for our patients. It is our joint and individual responsibility daily to demonstrate to outpatients, prescribers, colleagues, and others that We Care! Physical Requirements The following physical activities described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions and expectations. While performing the duties of this job, the employee is continuously required to sit and talk or hear. The employee is occasionally required to stand; walk; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; and stoop, kneel, crouch or crawl. The employee must regularly lift and/or move up to 20 pounds and occasionally lift/or move up to 30 pounds. Specific vision abilities required by this job include close vision, peripheral vision, depth perception and the ability to adjust focus. EEO Statement The above statements are intended to describe the work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required. The duties and responsibilities of this position are subject to change and other duties may be assigned or removed at any time. AmeriPharma values diversity in its workforce and is proud to be an AAP/EEO employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, sexual orientation, gender identity, national origin, age, protected veteran status, or on the basis of disability or any other legally protected class.

This position will perform collections and medical billing for various regional and national payers, including Federal, State, Third Party (HMO, PPO, IPA, TPA Indemnity) and Patient Billing. Must possess detailed knowledge of all medical benefit levels and have a thorough understanding of Federal, S

Certified Professional Biller (CPB), Certified Billing and Coding Specialist (CB Certified Medical Billing Specialist Certificate (CMBS) or similar certification. Reporting to the Chief Financial Officer (CFO), the Medical Billing Manager will be responsible for billing operations including workflow

Job DescriptionDescriptionWe are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Orange County market. In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy for our providers. You’ll translate your findings into actionable insights, creating and delivering education to providers and practice leaders while navigating complex conversations. Additionally, you’ll track and report on key performance metrics—such as HCC recapture rates, AWVs, and other KPIs, helping drive provider performance and overall program success. We are seeking candidates who have experience with risk adjustment experience, and we are open to training those without previous provider education experience! This position requires travel to provider offices up to 50% of the time OC. Our Values: • Put Patients First, • Empower Entrepreneurial Provider and Care Teams, • Operate with Integrity & Excellence, • Be Innovative, • Work As One Team What You'll Do • Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company, • Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC), • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines, • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation, • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing, • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements., • Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives., • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work., • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager., • May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I, • Other duties as assigned Qualifications • Required Certification/Licensure: Must possess and maintain AAPC or AHIMA certification - Certified Coding Specialist (CCS-P), CCS, or CPC., • At least 3 years of experience in risk adjustment coding and/or billing experience required, • Reliable transportation/Valid Driver’s License/Must be able to travel up to 75% of work time, • PC skills and experience using Microsoft applications such as Word, Excel, and Outlook, • Excellent presentation, verbal and written communication skills, and ability to collaborate, • Must possess the ability to educate and train provider office staff members, • Proficiency with healthcare coding software and Electronic Health Records (EHR) systems.You're great for this role if:, • Strong billing knowledge and/or Certified Professional Biller (CPB) through APPC, • Certified Risk Adjustment Coder (CRC) and/or Risk Adjustment coding experience, • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage, • Strong PowerPoint and public speaking experience, • Ability to work independently and collaborate in a team setting, • Experience with Monday.com, • Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting Environmental Job Requirements and Working Conditions • The national target pay range for this role is $72,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors., • This role follows a hybrid work structure where the expectation is to work on the field and at home on a weekly basis. This position requires up to 75% travel to provider offices in Orange County. Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation. Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

Job DescriptionDescription: Orthopedic Medical Biller and Collector We are seeking a detail-oriented and experienced Orthopedic Medical Biller and Collector to join our healthcare team. This role is vital in ensuring accurate billing processes and effective collection of payments, contributing to the financial health of our practice while providing excellent service to our patients. Key Responsibilities: • Prepare and submit accurate insurance claims for orthopedic services in a timely manner, • Review patient accounts for billing discrepancies and resolve issues promptly, • Follow up on unpaid claims and outstanding balances with insurance companies and patients, • Maintain detailed records of billing and collection activities, • Communicate effectively with patients regarding billing questions and payment options, • Stay updated on insurance policies, coding changes, and healthcare regulations related to orthopedics, • Collaborate with clinical staff to ensure proper documentation for billing purposes Skills and Qualifications: • Proven experience in medical billing and collections, preferably in orthopedics or a related specialty, • Knowledge of medical coding (CPT, ICD-10) and billing software, • Strong understanding of insurance processes and reimbursement procedures, • Excellent communication and interpersonal skills, • Attention to detail and high level of accuracy, • Ability to work independently and as part of a team, • Familiarity with healthcare regulations and compliance standards Join our dedicated team committed to providing exceptional patient care and maintaining efficient financial operations. We offer a supportive work environment with opportunities for growth and professional development. Requirements: Skills and Qualifications: • Proven experience in medical billing and collections, preferably in orthopedics or a related specialty, • Knowledge of medical coding (CPT, ICD-10) and billing software, • Strong understanding of insurance processes and reimbursement procedures, • Excellent communication and interpersonal skills, • Attention to detail and high level of accuracy, • Ability to work independently and as part of a team, • Familiarity with healthcare regulations and compliance standards

Job DescriptionBenefits: • Competitive salary, • Paid time off, • Training & development About ZapZzz: ZapZzz is a specialized sleep apnea treatment program with a mission of improving patients’ overall health and quality of life by providing advanced, patient-centered solutions for sleep apnea. We are committed to excellence in care, professionalism, and compliance while ensuring patients have access to the treatment they need. We are seeking a dedicated and detail-oriented Medical Biller with experience in sleep apnea billing. The ideal candidate will bring both technical expertise and a proactive approach to managing insurance claims, billing processes, and revenue cycle operations. Position Summary: The Medical Biller will be responsible for accurately preparing, submitting, and managing insurance claims related to sleep apnea treatment and oral appliance therapy. This role requires a thorough understanding of insurance verification, billing codes, compliance guidelines, and patient account management. The Medical Biller will play a critical role in ensuring timely reimbursement and supporting the financial health of the program. Key Responsibilities: · Prepare, review, and submit accurate insurance claims for sleep apnea treatments and devices in compliance with industry standards and payer requirements. · Conduct insurance verification, confirm patient eligibility, and obtain pre-authorizations as required. · Review and reconcile Explanation of Benefits (EOBs); identify, investigate, and resolve claim discrepancies, rejections, and denials in a timely manner. · Accurately post payments, adjustments, and patient balances while maintaining detailed account records. · Serve as the primary point of contact for insurance companies and patients regarding billing inquiries. · Maintain current knowledge of ICD-10, CPT, and HCPCS coding, with an emphasis on sleep-related services. · Generate financial and billing reports, providing insights to support program performance and revenue cycle efficiency. · Ensure compliance with HIPAA and other federal and state billing regulations. · Collaborate closely with clinical and administrative staff to streamline billing processes and provide a seamless experience for patients. Qualifications: · Minimum of 2 years of experience in medical billing, preferably with sleep medicine. · Strong knowledge of ICD-10, CPT, and HCPCS coding related to sleep apnea and oral appliance therapy. · Demonstrated experience with insurance verification, claims management, and reimbursement processes. · Proficiency in medical billing software, electronic claims submission, and Microsoft Office Suite. · Strong analytical and problem-solving skills with exceptional attention to detail. · Effective communication and interpersonal skills, with the ability to interact professionally with patients, insurance representatives, and team members. · High level of integrity, confidentiality, and commitment to compliance. Preferred Qualifications: · Prior experience with dental sleep medicine billing and oral appliance therapy claims. · Familiarity with major insurance providers’ sleep apnea coverage requirements. · Certification in medical billing and coding (CPC, CPB, or equivalent) is a plus. What We Offer: · Competitive compensation package (3% of Collections) · Supportive and professional work environment. · Opportunities for career development in a growing specialty field. · The chance to make a meaningful difference in patients’ lives by facilitating access to critical sleep apnea care.

Job DescriptionDescription: We are seeking a detail-oriented and knowledgeable Medical Biller to join our medical practice. The ideal candidate will be responsible for managing billing processes, ensuring accurate coding and submission of claims, and maintaining medical records. This role is crucial in facilitating the financial operations of our medical office while ensuring compliance with healthcare regulations. Requirements: Responsibilities • Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management, • Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection, • Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues, • Follow up on claims using various systems, such as practice management, EHR, and clearinghouse., • Maintains contacts with other departments to obtain and analyze additional patient information to document and process billings, • Prepares and analyzes accounts receivable reports and weekly and monthly financial reports in concert with the Practice Administrator and Operations Manager. Collects and compiles accurate statistical reports, • Audits current procedures to monitor and improve the efficiency of billing and collections operations, • Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol and are in compliance with Federal, State, and payer regulations, guidelines, and requirements, • Participates in the development and implementation of operating policies and procedures, • Analyzes trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures with the approval of the Director of Operations., • Keep up to date with carrier rule changes and distribute the information within the practice, • Performs physician credentialing actions Required Skills • Proficiency in medical coding (ICD-10, ICD-9) and familiarity with DRG systems., • Strong understanding of medical records management and medical terminology., • Experience in a medical office setting with knowledge of billing software and systems., • Excellent attention to detail with strong organizational skills., • Ability to communicate effectively with patients, healthcare providers, and insurance representatives., • Problem-solving skills to address billing issues efficiently and effectively.

Job Description Medical Biller/Surgery Scheduler/Front Desk (Newport Beach) Busy OB/GYN medical office in Newport Beach is looking for a biller, front office administrator and front desk coordinator/receptionist/scheduler/phones. Tasks include: · Medical Billing and Surgery Scheduling • Handling front office responsibilities, greeting patients, answering phones. Very welcoming · The ability to multitask effectively (phones, patients, orders) · Must be comfortable discussing financial information with patients · Detail oriented (recognize incorrect patient info as compared to insurance info) · Excellent communication skills · Confidence with computer applications · Coordination with patients in office and phones, answering phone calls and follow up Looking for: 1. Competence in communication and organization skills, detail oriented, 2. Competence in continuous improvement, accountability, and teamwork3. The ability to multitask effectively (phones, patients, orders), 3. Must be comfortable discussing financial information with patients, 4. Work well with others and ability to work independently, 5. Interest in the medical field a plus, 6. Most importantly -- VERY friendly with our patients (we have a very pleasant and supportive work environment). Must be extremely pleasant on the phone and in the office with our patients., 7. Must be willing to cross train in all areas of the business We are looking for someone highly motivated to learn and who is a quick learner, and is looking for a job long term. Preferred Position Qualifications Experience: Preferred but not required. Willing to train the right candidate without experience. License: n/a Other: Job Details: Approximately 35-40 hours a week. Monday through Friday, between the hours of 8:30-5. Salary: DOE

Job DescriptionDescription: This position will perform collections and medical billing for various regional and national payers, including Federal, State, Third Party (HMO, PPO, IPA, TPA Indemnity) and Patient Billing. Qualified candidates must be able to (1) Review accounts for billing accuracy in order to maximize reimbursement. (2) Persuasive and tenacious follow-up on claims status (3) Appeal, and re-bill or forward claims for recalculation and / or adjudication as necessary. Must possess detailed knowledge of all medical benefit levels and have a thorough understanding of Federal, State, PPO, HMO, and Indemnity Plans structure. Must meet or exceed the standard level of performance on assigned accounts. ESSENTIAL RESPONSIBILITIES: • Data entry, correct insurance assignment to patient accounts, insurance eligibility verification. Review/update demographics and patient information for accuracy., • Working knowledge of appropriate coding systems; CPT, ICD-9 and HCPCS, coverage; LCD/NCD and reimbursement associated with such codes., • Processing, validation of payer requests and processed claims via correspondence, remittance advice and EOBs (i.e., identification of payment discrepancies, inappropriate requests), • Investigate all denied services to determine the reason for the service denial, appeal, if appropriate. Identify, report root causes associated with denials, • Timely, effective processing of assigned appeals including development, submission, tracking, reporting and evaluation of appeal outcomes (i.e., next steps, improved outcomes), • Maximize utilization of Billing system, tools, and resources to support cash collection activities., • Review and work various reports including aging, adjustments and credit balances., • Comply with Federal and State legislation pertaining to all billing related matters., • Comply with all Safety, Emergency, Hazard, OSHA, HIPAA, Quality Assurance and Administrative Plans, Policies, Guidelines, Protocol, and Standards., • Support and maintain department cash and DSO goals, • Other duties as assigned The above list represents the general duties considered essential functions of the job and is not to be considered an exhaustive description of all the work requirements that may be inherent in the position. Requirements: High School Diploma and a minimum of four years related experience or a Bachelor’s degree from a four-year college or university; or equivalent combination of education and experience • Working knowledge and prior hands-on experience of medical billing and reimbursement. Credentialing experience a plus. -Proficient in Microsoft Outlook, Excel, Word, the Inter and Intranet and other programs/software as necessary. • Problem solving skills, using good judgment, attention to detail and follow-through are a must., • Excellent customer service skills; excellent verbal and written communication skills. Ability to prioritize work, multi-task and time management skills., • Ability to easily adapt to increased business demands, • Ability to effectively work with and resolve complex accounts & billing issues, • • Establish and maintain cohesive and good working relationships., • Excellent communication and customer service skills; cooperative, work collaboratively and treat others in respectful, professional and supportive manner.

Job DescriptionDescription: Job Title: Biller I Salary: $23 - $26 per hour DOE Location: Tustin, CA Openings: 1 Full-time Position Purpose: The Biller I position is an entry-level biller responsible for processing basic billing duties at Families Together of Orange County. The position requires some experience in at least one of the specialties listed below with the understanding that additional training will be required to gain experience of the other listed specialties. This role focuses on learning multi-specialty billing and its workflows, system navigation, and foundational claim processing under close supervision. This position supports all service lines directly or during special projects, including but not limited to: · Medical · Behavioral Health · Medical Specialties FTOC’s Expectations of all Employees • Adheres to all FTOC Policies and Procedures., • Providing the upmost customer service experience to all clients, • Conducts self in a manner that always represents FTOC’s core values., • Maintains a positive and respectful attitude with all work-related contacts., • Communicates regularly with immediate supervisor about Departmental and FTOC concerns., • Consistently reports to work as scheduled and in a timely manner prepared to perform the duties of the position., • Meets productivity standards and performs duties as workload necessitates., • Ability to train on all Learning Management Systems (LMS) by self-learning models from FTOC’s EMR. Core Duties and responsibilities, include but are not limited to: 1. Assist with daily claim submission across various service lines, 2. Data entry of all patient demographics and insurance information in EMR/billing systems, 3. Support charge entry and basic claim scrubbing, 4. Review basic claim rejections and assist with corrections, 5. Track claim status using payer portals and clearinghouse tools, 6. Post payments, 7. Assist in identifying simple denial reasons (eligibility, missing information, duplicates), 8. Works under close supervision of other team members, 9. Focus on learning systems, workflows, and payer rules, 10. Develops foundational billing knowledge of services provided by FTOC, 11. Strong attention to detail is mandatory, 12. Ability to follow structured workflows, 13. Take initiative and be proactive, 14. Open to learning and constructive feedback, 15. All other duties as assigned *This job description in no way states or implies that these are the only duties to be performed by the employee. He or she will be required to follow any other instructions and to perform other duties, within scope, as assigned by his or her supervisor. Teamwork and Interpersonal Skills: • Displays an awareness of others' needs and consistently acts in their best interests., • Exhibits courtesy, mutual respect, and compassion in all interactions with others., • Takes initiative to propose constructive solutions to challenges., • Recognizes and respects differences while actively seeking more effective communication approaches., • Demonstrates a positive and professional response to changes and challenges., • Nurtures positive working relationships and contributes to a collaborative work environment., • Exhibits effective teamwork, working cohesively to support the organization in achieving its goals and objectives., • Adapts smoothly to shifting workplace priorities., • Attends and actively participates in scheduled meetings, whether weekly, bi-weekly, or monthly. Requirements: Education, Qualifications, and Experience: · Billing or Coder Certification · 0–2 years in medical billing or healthcare administrative support · Basic understanding of medical billing concepts · Able to grasp new concepts quickly and efficiently · Experience utilizing billing systems (EMR/EHR) efficiently Work Schedule: • FTOC is an in-person organization first, and foremost. Employees are expected to be on-site for their scheduled shifts., • Hours of operation are Monday to Friday 8 a.m. to 8 p.m., however, employee schedules vary, depending on organizational, staffing, community, and patient needs. As such, FTOC may need to modify work schedules to meet such needs., • Holidays and weekends may be required depending on an employee’s department due to organizational, staffing, community, and patient needs as FTOC continues to grow and expand work days and hours., • Overtime may also occur due to organizational, staffing, community, and patient needs. Work Location: • Tustin, CA, • While employees may be assigned a primary site (Tustin, Garden Grove, Fountain Valley, Wellness Center, Mobile Units, Treehaven, Magnolia, Telehealth, etc.), employees may be required to temporarily fill in at another site based on organizational, staffing, community, and patient needs. Travel Requirements: • Occasional travel will be required. Employees must be able to travel to FTOC sites as needed, including with short notice. Physical Demands and Working Conditions: • The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions., • While performing the duties of this job, the employee may be required to drive to FTOC facilities as needed. The ability to sit for extended periods of time, and the ability to occasionally lift and/or move up to 25 pounds.

Job DescriptionPosition Summary Oso Home Care is seeking an experienced Home Infusion Biller to join our Billing & Reimbursement Department. Since 1984, Oso Home Care has been a leader in specialty home infusion pharmacy, ambulatory infusion center (AIC) services, and home health throughout Southern California. The Home Infusion Biller is responsible for the accurate and timely billing of specialty infusion pharmacy medications, supplies, nursing services, and ambulatory infusion center (AIC) services. This position manages the billing process from claim creation through reimbursement by ensuring claims are submitted accurately, claim edits are resolved, denials are appealed, and insurance follow-up is completed in accordance with payer requirements. The Home Infusion Biller works closely with Intake, Authorization Specialists, Benefits Verification, Pharmacy, Nursing, Reimbursement, and Revenue Cycle teams to ensure complete documentation, accurate billing, and timely reimbursement while maintaining compliance with Medicare, Medi-Cal, commercial insurance, and accreditation standards. Essential Duties and ResponsibilitiesMedical Billing • Prepare, review, and submit accurate electronic and paper claims for home infusion pharmacy services, infusion nursing visits, ambulatory infusion center (AIC) treatments, specialty medications, and related services., • Ensure all billing is supported by physician orders, nursing documentation, delivery records, medication administration records, and required clinical documentation., • Submit claims utilizing appropriate HCPCS, CPT, ICD-10-CM, NDC, modifiers, and payer-specific billing requirements., • Review claims for completeness and accuracy prior to submission., • Ensure claims are billed within established departmental turnaround standards.Claim Processing, • Review electronic claim edits and clearinghouse reports., • Correct billing errors and resubmit rejected claims., • Resolve claim edits related to coding, documentation, eligibility, authorization, or payer requirements., • Monitor claim acceptance and payment status through payer portals and electronic remittance systems.Denial Resolution, • Research denied and partially paid claims., • Determine the cause of denials and implement corrective actions., • Prepare corrected claims and supporting documentation for resubmission., • Submit appeals when appropriate and monitor payer response timelines., • Collaborate with Intake, Authorization Specialists, Pharmacy, Nursing, and physician offices to obtain additional documentation needed for reimbursement.Insurance Follow-Up, • Follow up on outstanding claims with Medicare, Medi-Cal, Managed Medi-Cal, Medicare Advantage, PPO, HMO, and commercial insurance carriers., • Review Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs) for payment accuracy., • Resolve claim payment discrepancies, coordination of benefits (COB), underpayments, and contractual adjustments., • Maintain detailed documentation of all payer communications and account activity.Revenue Cycle Collaboration, • Work collaboratively with Intake, Authorization, Benefits Verification, Pharmacy, Nursing, and Reimbursement teams to resolve billing issues that impact reimbursement., • Identify trends that contribute to billing delays or denials and communicate recommendations for process improvement., • Assist with payer audits, documentation requests, and reimbursement reviews.Compliance, • Maintain compliance with:, • Medicare and Medi-Cal billing regulations, • Commercial payer billing requirements, • CMS reimbursement guidelines, • HIPAA Privacy and Security Rules, • ACHC accreditation standards, • California Board of Pharmacy regulations, • Company policies and procedures, • Maintain confidentiality of patient health information in accordance with HIPAA.Minimum Qualifications, • High School Diploma or equivalent required., • Associate degree in Medical Billing, Healthcare Administration, or related field preferred., • Minimum of 2 years of medical billing or collections experience in Home Infusion, Specialty Pharmacy, Home Health, or Infusion Services., • Experience with CPR+ (Mediware), CareTend, or similar healthcare billing software preferred., • Experience billing Medicare, Medi-Cal, Managed Medi-Cal, Medicare Advantage, PPO, HMO, and commercial insurance plans.Knowledge, Skills & Abilities, • Thorough knowledge of medical billing procedures and revenue cycle processes., • Working knowledge of Medicare, Medi-Cal, and commercial payer billing requirements., • Knowledge of CMS reimbursement guidelines., • Familiarity with HCPCS, CPT, ICD-10-CM, and NDC coding., • Understanding of insurance eligibility, benefits verification, coordination of benefits, and prior authorization requirements., • Knowledge of medical terminology and infusion pharmacy services., • Proficiency with Microsoft Office Suite (Word, Excel, Outlook) and electronic medical record (EMR) systems., • Strong analytical, organizational, and time management skills., • Excellent written and verbal communication skills., • Ability to prioritize multiple tasks while meeting productivity and billing deadlines., • Strong mathematical skills with the ability to calculate payments, contractual adjustments, percentages, and reimbursement variances.Core Competencies, • Medical Billing, • Revenue Cycle Knowledge, • Attention to Detail, • Critical Thinking, • Problem Solving, • Time Management, • Customer Service, • Communication, • Teamwork, • Accountability, • Regulatory Compliance, • Organizational SkillsPerformance Expectations The Home Infusion Biller is expected to: • Submit accurate and timely claims with a high clean claim rate., • Maintain productivity standards for billing and insurance follow-up., • Resolve claim denials within established turnaround times., • Maintain accurate documentation of all billing activity., • Support departmental goals related to reimbursement, accounts receivable, and cash flow., • Maintain compliance with all payer, regulatory, accreditation, and company requirements. Collection-based incentive opportunities may be available based on departmental performance and company policy. About Oso Home Care Founded in 1984, Oso Home Care is a privately owned specialty home infusion pharmacy providing infusion therapy, ambulatory infusion services, and home health care throughout Southern California. We are committed to delivering exceptional patient care through clinical excellence, innovation, compassion, and teamwork. Oso Home Care is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other status protected by applicable federal, state, or local law.

Job DescriptionDescriptionWe are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Orange County market. In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy for our providers. You’ll translate your findings into actionable insights, creating and delivering education to providers and practice leaders while navigating complex conversations. Additionally, you’ll track and report on key performance metrics—such as HCC recapture rates, AWVs, and other KPIs, helping drive provider performance and overall program success. We are seeking candidates who have experience with risk adjustment experience, and we are open to training those without previous provider education experience! This position requires travel to provider offices up to 50% of the time OC. Our Values: • Put Patients First, • Empower Entrepreneurial Provider and Care Teams, • Operate with Integrity & Excellence, • Be Innovative, • Work As One Team What You'll Do • Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company, • Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC), • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines, • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation, • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing, • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements., • Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives., • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work., • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager., • May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I, • Other duties as assigned Qualifications • Required Certification/Licensure: Must possess and maintain AAPC or AHIMA certification - Certified Coding Specialist (CCS-P), CCS, or CPC., • At least 3 years of experience in risk adjustment coding and/or billing experience required, • Reliable transportation/Valid Driver’s License/Must be able to travel up to 75% of work time, • PC skills and experience using Microsoft applications such as Word, Excel, and Outlook, • Excellent presentation, verbal and written communication skills, and ability to collaborate, • Must possess the ability to educate and train provider office staff members, • Proficiency with healthcare coding software and Electronic Health Records (EHR) systems.You're great for this role if:, • Strong billing knowledge and/or Certified Professional Biller (CPB) through APPC, • Certified Risk Adjustment Coder (CRC) and/or Risk Adjustment coding experience, • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage, • Strong PowerPoint and public speaking experience, • Ability to work independently and collaborate in a team setting, • Experience with Monday.com, • Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting Environmental Job Requirements and Working Conditions • The national target pay range for this role is $70,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors., • This role follows a hybrid work structure where the expectation is to work on the field and at home on a weekly basis. This position requires up to 75% travel to provider offices in Orange County. Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation. Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

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