
51 - 200 funcionários
Fundada em 2023
🧘 Bem-estar
🌍 Impacto Social
Wellness • Social Impact
Nossa missão é transformar a saúde e o bem-estar geral das comunidades que servimos. Comprometemo-nos a fornecer assistência médica, serviços de saúde comportamental e apoio social com compaixão, equidade e individualização para permitir que as pessoas alcancem seu máximo potencial de vida.
🕒 Agosto 7, 2025
🏄 California – Remoto
💵 $22 - $24 / hora
⏰ Tempo Integral
🟢 Júnior
📊 Especialista em Faturamento
🚫👨🎓 Sem graduação necessária
🗣️🇺🇸🇬🇧 Inglês obrigatório
Melhore suas chances de conseguir uma entrevista verificando sua pontuação de currículo antes de se candidatar.

51 - 200 funcionários
Fundada em 2023
🧘 Bem-estar
🌍 Impacto Social
Wellness • Social Impact
Nossa missão é transformar a saúde e o bem-estar geral das comunidades que servimos. Comprometemo-nos a fornecer assistência médica, serviços de saúde comportamental e apoio social com compaixão, equidade e individualização para permitir que as pessoas alcancem seu máximo potencial de vida.
• The Billing Specialist plays a key role in ensuring accurate documentation, timely billing, and regulatory compliance across member and patient services. • This role supports long-term care coordination programs and works cross-functionally with case managers, patient coordinators, and finance staff to ensure accurate reimbursement, efficient claims management, and billing compliance with Medicaid and consolidated health plans. • Collaborate with case managers, social workers, patient coordinators, and other staff to ensure complete documentation of patient care plans, services provided, and changes in condition or level of care. • Assign accurate medical codes (e.g., ICD-10, other relevant codes) for diagnoses, treatments, and services in long-term care settings. • Prepare and submit claims to Medicaid and other payers, ensuring proper documentation and compliance with guidelines. • Create invoices and claims for member/patient interactions and outreach activities. • Ensure compliance with consolidated billing requirements, confirming all services are billed by Pacific Health Group as the designated entity. • Review, analyze, and appeal denied claims as needed; gather additional documentation or clarification from internal teams to support resubmission. • Monitor and manage accounts receivable; follow up with payers and health plans to resolve delays or discrepancies and ensure timely reimbursement. • Reconcile payer reimbursements with submitted claims to maintain accurate billing records. • Stay current with changes in billing regulations, long-term care reimbursement policies, and coding guidelines to ensure ongoing compliance. • Provide training or guidance to internal teams on documentation and billing procedures to support accurate and compliant submissions. • Perform other related duties as assigned by management.
• 1–2 years of experience in medical billing, preferably in long-term care, managed care, or Medicaid environments • Working knowledge of ICD-10 and consolidated billing processes • Familiarity with denial management, appeals, and accounts receivable follow-up • Strong attention to detail and documentation accuracy • Ability to work independently and manage multiple tasks and deadlines • Excellent communication skills for working cross-functionally with internal staff and external payers • Proficiency in medical billing software and standard office tools • Associate’s degree or medical billing/coding certification preferred
• 160 Hours of Paid Time Off (PTO) • 12 Paid Holidays per year, including your birthday and one floating holiday after 1 year of employment • 4 Paid Volunteer Hours per Month to support causes you care about • Bereavement Leave, including Fur Baby Bereavement • 90% Employer-paid Employee-Only Medical Benefits • Dental and Vision Insurance • FSA | Dependent Care Account • 401(k) with Company Match • Monthly Stipend • Short-Term & Long-Term Disability | AD&D • Employee Assistance Program (EAP) • Employee Discounts via Great Work Perks and Perks at Work • Quarterly In-Person Events • Fully remote work within California • Opportunities for professional development and internal growth • Equal Opportunity Employer
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