Senior Medical Billing Specialist
2 days ago
Sacramento
Senior Medical Billing Specialist Location: SF Bay Area, CA (Onsite – 5 days/week) Employment Type: Full-Time, Permanent Compensation: Competitive base salary + annual bonus + full benefits About the Opportunity We are partnering with an innovative medical technology and healthcare services organization that supports patients through technology-enabled care programs. This team plays a critical role in managing and optimizing reimbursement across professional medical billing, payer engagement, and revenue cycle operations for outpatient and digitally delivered healthcare services. This role is ideal for a hands-on, detail-oriented medical billing professional who thrives in end-to-end ownership, payer research, data analysis, and continuous process improvement. You will serve as a key contributor ensuring accurate, compliant, and efficient reimbursement while collaborating closely with cross-functional teams including operations, IT, and finance. Key Responsibilities • Perform comprehensive insurance eligibility and benefits verification through direct payer outreach, • Execute the full medical billing lifecycle, including charge entry, claim submission (CMS-1500 / 837), payment posting, AR follow-up, appeals, and denial resolution, • Research and interpret Medicare, Medicaid, and commercial payer policies, translating changes into operational billing practices, • Monitor and analyze accounts receivable aging, reimbursement trends, and denial patterns to identify risks and improvement opportunities, • Generate and maintain billing, reimbursement, and performance reports to support operational and financial decision-making, • Conduct audits and data clean-up initiatives to ensure billing accuracy and regulatory compliance, • Identify and implement strategies to improve first-pass claim acceptance rates and reduce revenue leakage, • Collaborate with internal stakeholders and technology teams to enhance billing workflows, reporting, and system functionality, • Maintain detailed documentation of billing activities, payer communications, and process updates, • Provide billing guidance and training to internal and external partners as needed, • Ensure strict adherence to HIPAA and healthcare billing regulations, • Support invoice distribution, payment tracking, and resolution of billing discrepancies, • Contribute to continuous improvement initiatives across the revenue cycle function Required Qualifications • Bachelor’s degree in healthcare administration, finance, accounting, business, or a related field, • 5+ years of hands-on experience in professional medical billing or revenue cycle operations, • Strong knowledge of CPT, ICD-10, and HCPCS coding and reimbursement methodologies, • Proven experience working with EHR / Practice Management Systems and billing software, • Solid understanding of payer reimbursement models, AR management, and denial workflows, • Experience producing and interpreting reimbursement, collections, and aging reports, • Advanced attention to detail with strong analytical and problem-solving skills, • Ability to work independently while managing multiple priorities in a fast-paced environment, • Excellent written and verbal communication skills with a customer-focused mindset, • Proficiency with Microsoft Office (Excel, Word, PowerPoint) and Google Workspace (Docs, Sheets, Slides) What’s Offered • Full-time, permanent position with regular business hours, • Competitive base salary plus annual performance bonus, • Comprehensive medical, dental, vision, and wellness benefits, • Paid time off and holidays, • Stable, collaborative onsite environment within the SF Bay Area MedTech ecosystem, • Opportunity to make a measurable impact on patient access and organizational performance
Barry S.Active 6 years ago
