Pacific Health Group · 5 months ago
Billing Analyst - California Residents ONLY at Pacific Health Group
United States
Full-time
Remote
Entry Level
$22/hr - $24/hr
1+ years expPacific Health Group is at the forefront of revolutionizing health and wellness. The Billing Analyst plays a key role in ensuring accurate documentation, timely billing, and regulatory compliance across member and patient services, supporting long-term care coordination programs and working cross-functionally with various teams.
Health CareHospitalMedicalTelehealth
Responsibilities
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
Qualification
Required
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
Preferred
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
Company
Pacific Health Group
Pacific Health Group delivers integrated Medi-Cal healthcare, behavioral health, and telehealth services tailored to individual needs.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Jennifer Guerguis
Co-Founder
Company data provided by crunchbase