CareMore Health · 8 hours ago
Senior Biller
Cerritos, CA
Full-time
Onsite
Senior Level
$22/hr - $33/hrCareMore Health is focused on delivering high-quality healthcare services, and they are seeking a Senior Biller to ensure the accuracy and compliance of billing activities. This role is crucial in optimizing revenue cycle performance and involves reviewing claims, managing accounts receivable, and collaborating with various departments to resolve billing issues.
Health CareMedicalPersonal HealthService Industry
Responsibilities
Review and analyze complex patient account files to ensure accuracy, completeness, and compliance with payer, regulatory, and CareMore Health billing standards
Prepare, review, and submit billings to primary and secondary insurance carriers, including Medicare and Medi-Cal, ensuring accuracy and timely submission
Lead the investigation and appeal of complex or high-value claim denials; prepare detailed documentation to support successful resolution and reimbursement
Monitor and manage assigned accounts receivable, focusing on high-dollar or aged accounts to drive collection efficiency and reduce outstanding balances
Partner with internal teams—coding, utilization management, finance, and provider operations—to resolve billing issues and identify process improvements
Prepare and submit refund requests, claim adjustments, and rebills as necessary to maintain compliance and revenue accuracy
Respond to escalated inquiries from patients, payers, and internal stakeholders in a professional, timely, and solutions-oriented manner
Support the training and mentoring of billing staff; assist in quality review and serve as an internal expert on complex billing questions and payer requirements
Contribute to revenue integrity initiatives, tracking billing and denial trends, and recommending process or system improvements to prevent recurrence
Maintain up-to-date knowledge of regulatory changes, payer policies, and billing system updates relevant to CareMore’s lines of business
Qualification
Required
Review and analyze complex patient account files to ensure accuracy, completeness, and compliance with payer, regulatory, and CareMore Health billing standards
Prepare, review, and submit billings to primary and secondary insurance carriers, including Medicare and Medi-Cal, ensuring accuracy and timely submission
Lead the investigation and appeal of complex or high-value claim denials; prepare detailed documentation to support successful resolution and reimbursement
Monitor and manage assigned accounts receivable, focusing on high-dollar or aged accounts to drive collection efficiency and reduce outstanding balances
Partner with internal teams—coding, utilization management, finance, and provider operations—to resolve billing issues and identify process improvements
Prepare and submit refund requests, claim adjustments, and rebills as necessary to maintain compliance and revenue accuracy
Respond to escalated inquiries from patients, payers, and internal stakeholders in a professional, timely, and solutions-oriented manner
Support the training and mentoring of billing staff; assist in quality review and serve as an internal expert on complex billing questions and payer requirements
Contribute to revenue integrity initiatives, tracking billing and denial trends, and recommending process or system improvements to prevent recurrence
Maintain up-to-date knowledge of regulatory changes, payer policies, and billing system updates relevant to CareMore's lines of business
Company
CareMore Health
CareMore Health provides healthcare delivery system.
Founded in 1993
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Paul Mikulecky, MD, MBA, CPE
VP & Chief Medical Officer
Lauren F Burns
Clinical Education Partner
Recent News
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