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.