Medical Billing Specialist

Position Overview

Ultimate Staffing Services is currently seeking a dedicated Medical Billing Specialist to join a dynamic team in California. This role is essential in ensuring the accurate and timely billing, claim submission, and payment posting for services provided. The specialist will play a critical role in maintaining compliance with HRSA, Medi-Cal, Medicare, and managed care billing requirements, supporting revenue integrity, and collaborating with clinical and administrative teams to resolve billing issues and reduce claim denials. This position is full-time and onsite, offering a chance to make a meaningful impact in the healthcare community.

Responsibilities

• Prepare, review, and submit claims for Medi-Cal (including FQHC PPS), Medicare, Medicare Advantage, and commercial managed care plans.
• Ensure claims comply with HRSA, CMS, and state-specific FQHC billing requirements.
• Apply correct CPT, HCPCS, ICD-10, and modifier coding in accordance with FQHC guidelines.
• Verify encounter eligibility, covered services, and required documentation prior to billing.
• Post payments, adjustments, and denials accurately and timely.
• Reconcile remittance advice (EOBs/ERAs) to claims submitted and identify underpayments, overpayments, and contractual variances.
• Review and analyze claim denials and rejections, initiate appeals, and provide supporting documentation as required.
• Maintain compliance with HRSA, CMS, Medi-Cal, and managed care billing regulations and support audits and reviews.
• Work closely with front office, clinical staff, coding, and eligibility teams to resolve billing discrepancies.
• Communicate professionally with payers, vendors, and internal departments, and respond promptly to provider and patient inquiries.

Qualifications

• High school diploma or equivalent required; Associate's degree in Health Information Management or Medical Billing Certification preferred.
• Minimum 1-2 years hands-on medical billing experience in an FQHC or similar healthcare setting required.
• Knowledge of CPT, ICD-10, HCPCS, modifier usage, and payer billing requirements.
• Proficient in medical billing software and EHR systems (e.g., NextGen, eClinicalWorks, Athena).
• Excellent data entry accuracy, organizational skills, and attention to detail.
• Effective written and verbal communication skills.
• Strong customer service and interpersonal skills.
• Solid understanding of HIPAA regulations and healthcare data confidentiality standards.
• Ability to work extended hours during close-out/reconciliation periods.

Required Work Hours

The position requires full-time hours, typically from 8:00 AM to 5:00 PM, Monday through Friday.

Benefits

The salary for this position ranges from $23.69 to $25.00 per hour, depending on experience and qualifications.

Additional Details

The Medical Billing Specialist will work onsite in California, contributing to the organization's mission of providing quality healthcare services to the community.

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, Los Angeles County Fair Chance Ordinance, and San Francisco Fair Chance Ordinance.