Medical & Regional Center Billing Specialist for a Speech and Language Pathology Center
Location: Mission Hills, CA
Employment Type: Full-Time
Compensation: Non-exempt, $26 to $30 per hour (DOE)
About the Position
We are seeking a highly skilled and detail-oriented Medical & Regional Center Billing Specialist to join our team in Mission Hills. This dual-focused role requires expertise in both traditional medical billing and specialized Regional Center billing processes. The ideal candidate will possess a comprehensive understanding of insurance claims management, billing procedures, and the unique requirements of Regional Center service billing.
Key Responsibilities
Medical Billing
- Process and submit clean claims to private insurance companies
- Verify patient insurance eligibility and benefits prior to service delivery
- Follow up on unpaid, denied, or partially paid claims to ensure maximum reimbursement
- Post payments and adjustments accurately in billing systems
- Generate patient statements and manage the accounts receivable aging process
Regional Center Billing
- Process and submit claims to California Regional Centers following their specific billing guidelines and requirements
- Understand and maintain compliance with Department of Developmental Services (DDS) regulations
- Track authorization units and ensure services billed match authorized services
- Reconcile Regional Center remittance advices and resolve discrepancies
- Maintain accurate documentation for audit purposes
General Duties
- Ensure compliance with federal, state, and insurance regulations, including HIPAA
- Resolve billing discrepancies and respond to patient/client inquiries regarding billing
- Generate and analyze financial reports for both medical and Regional Center billing
- Stay updated on changes in billing regulations, coding requirements, and fee schedules
- Collaborate with clinical staff to ensure accurate documentation for billing purposes
Required Experience & Skills
- Minimum 2 years of experience in medical billing, with at least 1 year handling Regional Center billing (preferred)
- Demonstrated proficiency with medical billing software and electronic health record (EHR) systems
- Thorough knowledge of CPT, ICD-10 coding, and medical terminology
- Understanding of Regional Center service codes and billing procedures
- Experience with insurance verification, claim submission, and denial management
- Strong analytical skills and attention to detail
- Excellent communication abilities for patient/client interactions and interdepartmental collaboration
- Ability to work independently and manage multiple priorities effectively
Preferred Qualifications
- Certified Professional Biller (CPB) or similar certification, or 4 plus years of experience
- Experience with specific Regional Centers in Southern California
- Knowledge of Service Coordinator interactions and authorization processes
- Familiarity with audit preparation for both medical and Regional Center billing
- Spanish language proficiency a plus
We are an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other characteristic protected by applicable law.