Medical Biller/Collections Specialist

An Ambulatory Surgery Center in Los Angeles is in the need of a Medical Biller/Collections Specialist. This Medical Biller/Collections Specialist is ideal for someone who understands the full revenue cycle and can confidently manage claims, denials, and payer follow-up for surgical services. The right candidate for the Medical Biller/Collections Specialist role will bring healthcare billing experience, strong insurance knowledge, and the ability to keep accounts moving toward timely reimbursement.Responsibilities:• Manage end-to-end billing and collections activities for surgical services, from charge review through payment follow-up.• Confirm patient coverage, authorization details, and payer information using available electronic records and insurance carrier resources before claims are submitted.• Enter billing data and post charges accurately for surgical cases while maintaining complete and organized account documentation.• Pursue outstanding third-party balances by conducting regular follow-up with commercial and government payers across multiple plan types.• Investigate explanation of benefits, identify denial causes, correct claim issues, and resubmit claims to support reimbursement.• Monitor assigned claim queues and worklists each day to address unresolved accounts, aging items, and billing exceptions in a timely manner.• Review provider documentation, including urgent care and surgical records, to ensure charges are supported and billing can proceed accurately.• Apply appropriate diagnosis, procedure, medication, and supply codes based on clinical documentation and operative reports completed by providers.• Examine aged accounts and unresolved payer responses to resolve denials, appeals, and collection issues efficiently.