Billing Analyst

August 7

🏄 California – Remote

Although this job is listed in California, this company may be open to hiring remote in other states.

💵 $22 - $24 / hour

⏰ Full Time

🟢 Junior

📊 Billing Specialist

🚫👨‍🎓 No degree required

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Pacific Health Group

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Wellness • Social Impact

Pacific Health Group is a community-focused healthcare organization that delivers integrated medical, behavioral health, and social support services to improve the wellbeing of underserved populations. The organization provides enhanced care management for complex needs, behavioral health and substance-use treatment, community health worker outreach, street medicine for people experiencing homelessness, community support services (including housing assistance), and non-ambulatory medical transportation. Pacific Health Group partners with health plans and centers care on whole-person wellness, equity, and access across multiple locations.

51 - 200 employees

Founded 2023

🧘 Wellness

🌍 Social Impact

📋 Description

• 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.

🎯 Requirements

• 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

🏖️ Benefits

• 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