Associate Medical Biller/Collector CMRS

Associate Medical Biller/Collector CMRS

Winchester, CA $42,009 - $49,999 a year

Full Time

Position Overview

This role is responsible for the accurate and timely submission of medical claims to insurance providers across a variety of healthcare settings. The individual will ensure payments for medical services are received promptly and may act as a liaison between healthcare providers, patients, and insurance companies.

Key Responsibilities

• Maintain a safe and clean work environment, adhering to safety and infection control standards.
• Review patient billing information for accuracy and completeness, obtaining missing details as needed.
• Identify appropriate insurance parties to bill, including secondary and tertiary insurers.
• Utilize electronic health record (EHR) systems to perform billing tasks and maintain compliant medical records.
• Process claims and apply payments or credits accordingly.
• Verify insurance payments for accuracy and contract compliance.
• Investigate and resolve denied or partially paid claims by collaborating with involved parties.
• Manage assigned accounts to ensure timely payment of outstanding claims and follow up as necessary.
• Communicate effectively with healthcare providers, patients, and insurance representatives to clarify billing issues.
• Consult supervisors and team members to address billing and collection challenges.
• Follow established policies and procedures to maintain operational quality and escalate compliance concerns appropriately.
• Prepare reports and documentation as required.
• Perform administrative duties such as answering phones, faxing, filing confidential documents, and using email and internet tools.
• Deliver professional and courteous customer service to both internal and external stakeholders.
• Collaborate as a team member while meeting deadlines and productivity goals.

Qualifications

• Minimum of one year experience posting in a healthcare environment.
• Strong customer service skills with demonstrated leadership, teamwork, and cooperation.
• High ethical standards and professional integrity.
• Understanding of medical and surgical terminology.
• Knowledge and compliance with HIPAA regulations, maintaining strict confidentiality.
• Proficient with email, internet research, and payer websites.
• Preferred experience with billing software such as GE Centricity and SRS Caretracker.
• Excellent written, oral, and interpersonal communication skills; able to present ideas clearly and professionally.
• Highly self-motivated, detail-oriented, and able to prioritize tasks effectively in a fast-paced environment.
• Ability to interpret complex documents and respond appropriately to sensitive inquiries or complaints.

Education

• High school diploma or equivalent required.
• Associate's Degree in Business Administration preferred.

Certifications

• Certified Medical Reimbursement Specialist (CMRS) certification preferred.

All candidates must successfully complete a physical evaluation, drug screening, and background checks prior to employment. This position is based in a regional healthcare setting within the Pacific Southwest region of the United States.