Medical Billing & Denial Specialist

WE ARE TITANIUM HEALTHCARE

Titanium is a healthcare company that puts heart and compassion above all else. Millions of Americans just aren’t getting the medical care they need. We’re on a mission to change that. For patients that means exceptional support and better care. For providers it means better support and time to focus on patients, and for partners that means higher quality and lower cost.

Join us in our mission!

We are committed to advancing health equity through California’s CalAIM initiative, including the Enhanced Care Management (ECM), Community Supports (CS), and Health Home Program (HHP) programs. We support vulnerable members of our communities by providing high-quality, person-centered care coordination. Our teams are innovative, collaborative, and passionate about improving healthcare delivery.

POSITION SUMMARY

Titanium Healthcare is seeking a motivated Medical Billing & Denial Specialist to join our growing and dynamic team. This individual will be responsible for the posting, evaluating, and billing of claims and outstanding accounts receivable within the EHR (electronic health records) system. This includes evaluating EHR data integrity as it relates to account receivable, performing data entry, reporting, and billing tasks. In addition, the billing specialist will be responsible for ensuring that information is processed accurately, payments are posted, and denials are resubmitted in a timely fashion. This individual will work in collaboration with the revenue cycle, finance, and data team.

WHERE YOU’LL WORK

This position is hybrid. Work from home and come onsite to our Garden Grove office. Standard business hours are Monday through Friday from 8:00 am to 5:00 pm.

WHAT YOU’LL DO

Identify, notify, and work with internal team members on denial patterns and issues

Collaborate with direct manager and other team members to resolve issues timely

Evaluate patient accounts and take charge of insurance outstanding payments

Manage, track, and resolve complex denied and voided claims until the claim is paid

Achieve maximum reimbursement for services provided

Prepare and submit billing data and medical claims to insurance companies, including 837 and 1500 claims

Be proactive, creative, and flexible in determining, evaluating, researching, and resolving issues

Organize and prioritize multiple activities to meet all external and internal deadlines

Post payments accurately and timely to accounts

Collaborate with revenue cycle manager and operational leadership on frequent issues to consult and advise on how to correct errors

Develop and maintain claim resolution skills through continuous trainings, workshops, and education in collaboration with Revenue Cycle Manager

Check eligibility on a bi-monthly basis for clients and compiling list of clients with terminated Medi-Cal as needed and provide management and operations team reports

Prioritize tasks and create a tracking system of claims and health plans

Respond to requests and communication timely (within 24-48 hours)

Assist in the creation and review of billing procedures to ensure the company maintains compliance with local, state, and federal regulations

Perform other duties and projects assigned

WHO YOU ARE

Able to understand and become proficient in medical billing software

Familiarity with Medi-Cal, Medicare, commercial, and patient billing

Must have initiative, rely on experience, and sound judgement in making decisions in varied situations

Familiar with the utilization of an EHR (electronic health record) system

Ability to multi-task, prioritize, and see projects through to completion

Be able to work independently and is self-directed

Experience with primary care and Medi-Cal billing

Strong organizational and time management skills with attention to detail

Occasionally required to move or carry training materials or equipment weighing up to 15 pounds

Fluent in English (written and verbal)

Excellent verbal and written communication skills, including the ability to convey and exchange information in a clear and concise manner

Adequate hearing and vision (with corrective devices if necessary) 

Ability to identify problems and use logic and related information to develop and implement solutions

Ability to work independently and carry out assignments to completion within the parameters of established policies and procedures

Ability to communicate clearly in-person, by phone, and electronically

Frequent use of computers, keyboard, and handheld/mobile devices

Competent with computers, email, virtual platforms, and Microsoft Office based programs

Ability to type for extended periods

Must be able to remain in a stationary position

Ability to maintain professionalism and safety in diverse environments

Consistently operate a computer and office equipment in a home-office setting

WHAT YOU’LL NEED

Diploma/GED required

Associate degree in medical or another related field preferred. An equivalent combination of education and experience that provides the skills, knowledge, and ability to perform the essential job duties, which meets any required state or federal certification requirements

Minimum 3+ years of clinical AR, practice management, and/or medical administration experience

Distraction-free home workspace with a secure internet connection

NICE TO HAVES

Bilingual in Spanish

Bachelor's degree in healthcare administration, business administration, or related field

Prior experience using eClinicalWorks

WHAT YOU’LL ENJOY

Make an impact: an organization who cares about its employees, communities, and the future of healthcare

Inclusivity: be a part of a workplace where you not only belong but also can be the best version of yourself

Growth: opportunities to develop and grow your career with us

Community: you are encouraged to have a voice, share your opinions, and have individual impact on the business

Paid Time Off: 12 holidays and up to 3 weeks of accrued PTO to rest and recharge plus additional time for sick, jury duty, bereavement, and reproductive loss

Work Life Balance: enjoy flexibility to maximize your well-being and success with our hybrid work model

Medical, Dental, & Vision Benefits: we cover up to 100% of your premium and 50% of your dependents depending on the plan

Flexible Spending, Health Savings & Dependent Care Accounts

Life/AD&D insurance funded 100% by Titanium Healthcare

Supplemental Short-Term Disability

Employee Assistance Programs

Protect your pet(s) with Pet Insurance

401(k) plan 

EEO Statement

At Titanium Healthcare, our mission is to fearlessly reengineer the way healthcare works to reduce costs, ensure better outcomes, and provide everyone, everywhere, with the kind of compassionate and coordinated care they deserve. We believe that achieving this mission starts with a diverse and inclusive workforce.

Titanium Healthcare is an equal opportunity employer. We are committed to promoting and celebrating all backgrounds and encourage all applicants, regardless of race, religion, gender, sexual orientation, disability, age, marital status, parental status, military or veteran status, or any other legally protected status, to apply. We believe that diversity and inclusion drive innovation and equity in healthcare, enabling us to better serve our communities and make a lasting impact.