Medical Biller/Eligibility Coordinator

Job Description

Job Description Benefits/Perks

• Competitive Compensation
• Great Work Environment
• Career Advancement Opportunities

Job SummaryGlobal Pain Care is seeking a dependable, detail-oriented Billing & Eligibility Coordinator to join our team. The ideal candidate will have experience in medical billing, insurance eligibility verification, or both, with a good understanding of insurance requirements and reimbursement processes.This position involves verifying patient insurance coverage, reviewing benefits, processing medical claims, resolving billing issues, and working closely with clinical and administrative staff to ensure accurate and timely reimbursement. We are looking for someone who is organized, able to manage multiple responsibilities, and comfortable working in a fast-paced medical office.

Responsibilities
Insurance Eligibility & Verification

• Verify patient insurance eligibility, coverage, and benefits before scheduled appointments.
• Confirm copayments, deductibles, coinsurance, and other patient financial responsibilities.
• Identify insurance restrictions, referral requirements, and authorization needs.
• Communicate insurance discrepancies to the appropriate staff.
• Maintain accurate insurance information in the electronic health record (EHR) system.

Medical Billing & Claims

• Prepare, review, and submit medical claims to insurance carriers.
• Review claims for accuracy, including patient information, insurance details, and billing codes.
• Follow up on outstanding claims, rejected claims, and payment denials.
• Assist with payment posting, account reconciliation, and billing corrections.
• Review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs).
• Communicate with insurance representatives to resolve claim and reimbursement issues.
• Assist in monitoring accounts receivable and outstanding balances.
• Follow HIPAA requirements and maintain patient confidentiality.
• Perform other related duties as assigned.

Required Qualifications

• Previous experience in medical billing, insurance eligibility verification, or medical revenue cycle operations.
• Familiarity with medical insurance terminology and claims processing.
• Knowledge of Medicare, Medi-Cal, and commercial insurance plans.
• Strong organizational skills and attention to detail.
• Excellent communication and problem-solving abilities.
• Ability to work independently and manage multiple priorities.
• Proficiency with computers and electronic medical records.
• Knowledge of claim denials, appeals, and accounts receivable follow-up