Physician Biller

Location: San Diego, CA (Hybrid)

Salary: $31.04 - $40.95 per hour

Employment Type: Full-Time

Work Schedule: Monday - Friday, 8 Hours/Day

Department: Revenue Cycle Management

Open Positions: 1

Job Overview

We are seeking an experienced Physician Biller to join our Revenue Cycle Management team. This position is responsible for managing the complete physician billing cycle, including claim submission, payment tracking, denial resolution, and accounts receivable follow-up.

The ideal candidate will have a solid understanding of medical insurance billing, claims processing, payer requirements, and denial management. The selected individual will ensure accurate billing, resolve claim discrepancies, maintain compliance with healthcare regulations, and coordinate with internal departments and insurance representatives to support timely reimbursements.

This hybrid position includes a combination of onsite work at the Greenwich Drive location in San Diego and remote work.

Key Responsibilities

• Manage the complete physician billing cycle, from claim preparation and submission to payment posting and resolution.
• Review medical claims for accuracy and compliance with insurance requirements.
• Identify and resolve billing errors, claim rejections, and outstanding account issues.
• Investigate denied and underpaid claims, prepare appeals, and follow up with insurance carriers.
• Monitor assigned accounts receivable and prioritize outstanding claims for timely resolution.
• Review Explanation of Benefits (EOBs), payer correspondence, and supporting documents to determine appropriate billing actions.
• Obtain and submit medical records and additional documentation when required to support claims and medical necessity.
• Resolve claim edits and ensure all required billing documentation is attached.
• Coordinate with internal departments, insurance companies, and external business partners to address billing concerns.
• Maintain patient confidentiality and comply with HIPAA regulations and applicable healthcare billing standards.
• Meet departmental productivity, accuracy, and turnaround-time expectations.

Required Qualifications

• At least 3 years of experience in medical claims billing, denial management, and appeals, including at least 1 year of recent hands-on claims processing and resolution experience.
• Strong understanding of medical insurance billing procedures, claim forms, HIPAA, PHI, and federal and state billing regulations.
• Knowledge of medical terminology and coding systems, including CPT, HCPCS, ICD-10, and modifiers.
• Ability to interpret EOBs, insurance correspondence, and payer documentation to resolve outstanding claims.
• Experience with Epic Resolute Professional Billing.
• Proficiency in Microsoft Office applications, particularly Outlook, Excel, and Word.
• Minimum typing speed of 25 words per minute.
• Strong organizational, communication, and problem-solving skills.
• Ability to work independently and collaborate effectively with a team.

Preferred Qualifications

• Associate Degree or some college-level coursework.
• Medical Billing Certification.
• Three years of recent hands-on experience in medical claims processing and resolution.
• Experience with CMS-1500 claim forms.
• Ability to review medical records and identify documentation needed to establish medical necessity.
• Familiarity with payer-specific billing requirements and claim submission procedures.
• Experience verifying insurance eligibility and coverage through payer portals, Epic, and telephone communication.
• Knowledge of insurance claim adjudication processes.
• Experience handling prior authorizations and referrals.

Additional Requirements

• Flexibility to work at different locations and hours based on operational requirements.
• Successful completion of a criminal background check and pre-employment physical.
• Compliance with applicable workplace vaccination and health policies.
• Employment may be subject to drug screening.

Compensation

The hourly pay range is $31.04 to $40.95, equivalent to an estimated annual salary of $64,812 to $85,504 for full-time employment. Final compensation will depend on relevant experience, qualifications, skills, and organizational pay policies.

Equal Employment Opportunity

All qualified applicants will receive consideration for employment without discrimination. The employer is committed to maintaining an inclusive, professional, and supportive workplace.