Medical Billing Specialist

About Unicare

• Relentless pursuit of improved outcomes. We proactively solve problems, move quickly, and collaborate so every patient achieves the best possible clinical and quality-of-life results.
• Serious care delivered with compassion. We combine clinical rigor and high standards with empathy, warmth, and respect in every interaction.
• Patients and families first. Every decision is guided by what will most support the comfort, confidence, and daily lives of the people we serve.
• Experience matters as much as equipment. We deliver not only advanced technology, but also education, responsiveness, and ongoing support that make care easier at home.

Position Summary

How the Role Works

Key Responsibilities

• Prepare, review, and submit clean paper and electronic claims to government and commercial payers, with particular emphasis on California Medicaid ( Medi-Cal )
• Translate clinical documentation, inventory, and ICD-10 diagnoses into accurate, billable HCPCS codes for respiratory, DME, and supply items where required for billing
• Manage clearinghouse edits, errors, and rejections, correcting and resubmitting claims promptly to prevent delays
• Partner with the intake and qualification function to confirm claims are fully documented and billable before submission

• Process and post paper and electronic remittances (ERA/EOB) and patient payments accurately
• Reconcile posted payments against expected reimbursement and deposits, resolving variances
• Post denials and zero-pays, coding them correctly so denial trends can be tracked and worked
• Coordinate secondary and tertiary billing, submitting claims to downstream payers with correct primary remittance (COB) information once the primary adjudicates
• Manage patient billing, generating and sending statements for balances after insurance and responding to patient inquiries with professionalism and sensitivity to family circumstances
• Coordinate delinquent accounts with third-party collection agencies per company policy
• Work aging reports to keep AR days within target, prioritizing high-value and aging claims and escalating systemic payer issues
• Research and resolve denials, short-pays, and underpayments, identifying root cause and correcting for resubmission
• Prepare and file timely appeals with supporting documentation, tracking through to resolution
• Perform administrative and contractual adjustments accurately and within defined authority levels, maintaining clean and reconciled account balances
• Own overall AR integrity, keeping patient and payer balances accurate so financial reporting reflects true collectible revenue
• Identify denial and underpayment trends and surface them to leadership and to the intake function to drive front-end prevention

• Handle patient escalation calls to the office with strong customer service, protecting the patient and family experience at every touchpoint
• Maintain accurate patient and claim records in the billing system
• Coordinate with intake, documentation, and clinical teams to close gaps that affect reimbursement
• Work fluently in a technology-driven, automation-heavy environment, adopting billing platforms, clearinghouses, EMR/EHR systems, and workflow tools quickly and using them to work efficiently at scale
• Ensure billing practices comply with payer rules, CMS DMEPOS requirements, and applicable regulations

Qualifications

• 2+ years of DMEPOS medical billing experience across claims submission, payment posting, secondary/tertiary billing, patient billing, and denials/appeals
• Hands-on experience billing home respiratory therapies, including ventilators, oxygen therapy, CPAP, and BiPAP, and the documentation and billing requirements each carries
• Experience billing California Medicaid ( Medi-Cal ), Medicare, and commercial payers; strong Medi-Cal DMEPOS experience is a top priority
• Demonstrated experience billing home medical supplies and recurring supply drops, not solely capital equipment such as ventilators; supply-side fluency (resupply cadence, consumables, HCPCS for supplies) is essential
• Working knowledge of how DMEPOS documentation and ICD-10 diagnoses map to billable HCPCS codes and modifiers; formal medical coding certification is not required, what matters is practical DMEPOS billing fluency
• Patient-friendly customer service skills are critical; this role carries a meaningful volume of inbound and outbound patient and family calls, including escalations, and requires warmth, patience, and professionalism on every one
• A strong coordinator and team player who works closely with intake, clinical, and delivery colleagues so mission-aligned care is delivered and reimbursed without gaps
• Proficiency with the Microsoft Office suite (Outlook, Word, Excel) and a fundamental understanding of how EMR/EHR, order management, and billing systems work together
• Tech-savvy and comfortable in an automation-forward operation, with the aptitude to learn new systems fast and improve how work gets done rather than relying on manual process
• Uncompromising integrity, with a commitment to HIPAA compliance and to preventing fraud, waste, and abuse in every claim and account action
• Able to work full-time and onsite in Newbury Park, covering a standard 8-hour day plus lunch and present during core office hours of Monday through Friday, 9:00 AM to 4:00 PM PST
• Strong attention to detail, follow-through, and ownership

• Bilingual in English and Spanish, given the families we serve
• Pediatric and/or home respiratory (oxygen, PAP, ventilator, nebulizer) billing experience
• Experience building or tracking revenue cycle metrics and reporting to leadership
• Experience in a high-growth or ground-floor environment
• California Home Medical Device Retailer (HMDR) Exemptee certificate

Compliance and Integrity

What We Offer

• Medical, dental, and vision coverage
• Retirement plan
• Competitive paid time off (PTO)
• Competitive compensation [range to be added]