Medical Biller AR Insurance Collections

Known for our high standard of excellence, we provide compassionate, patient-centered care for both pediatric and adult patients. Our model combines hospitality-driven service with innovative technology solutions that streamline operations, improve clinical outcomes, and enhance the experience for both patients and providers.

At Modena, we aim to hire great people, treat them well, and help them find meaning and purpose in our mission. Our dedicated team values collaboration, positivity, and growth while striving to improve lives through expert diagnosis, treatment, and research. We are looking for high-energy, kind, and collaborative individuals eager to grow personally and professionally while making a meaningful impact in the lives of others.

We are currently hiring an Insurance Collector/Medical Biller to join our growing billing team and support the increasing demand for our services. This role offers strong opportunities for personal, professional, and financial growth.

As an Insurance Collector/Medical Biller, you will be responsible for reviewing clinical documentation and assigning accurate medical codes to ensure proper billing and reimbursement. In addition to processing claims and invoices, you will work closely with healthcare providers, insurance companies, and patients to verify coding accuracy, resolve billing-related issues, and support compliance with industry standards.

Position Summary

The Insurance Collector/Medical Billing Specialist is responsible for managing insurance accounts receivable for a busy Allergy & Asthma practice. This role focuses on timely follow-up of unpaid, denied, and underpaid claims to ensure maximum reimbursement while maintaining compliance with payer regulations and healthcare standards. The ideal candidate has experience with specialty physician billing, insurance collections, and denial management.

Essential Duties and Responsibilities

* Follow up on outstanding insurance claims with commercial payers, Medicare, Medicaid, and managed care organizations.
* Investigate and resolve denied, rejected, and underpaid claims related to allergy and asthma services.
* Submit claim corrections, reconsiderations, and appeals with appropriate documentation.
* Review Explanation of Benefits (EOBs), Electronic Remittance Advice (ERA), and payer correspondence.
* Monitor aging reports and prioritize accounts for collection activities.
* Verify patient eligibility, benefits, referrals, and authorization requirements.
* Ensure accurate reimbursement for allergy testing, immunotherapy injections, pulmonary function testing, biologic medications, and other specialty services.
* Collaborate with providers, clinical staff, and front-office personnel to resolve billing discrepancies.
* Document all collection efforts and account activity in the practice management system.
* Maintain compliance with HIPAA, payer guidelines, and company policies.
* Assist with identifying billing trends, recurring denials, and process improvement opportunities.
* Meet established productivity and collection goals.

Qualifications

* High school diploma or equivalent required; Associate's degree preferred.
* Minimum 2 years of medical billing and insurance collections experience, preferably in an Allergy & Asthma, Pulmonary, ENT, or specialty physician practice.
* Knowledge of medical terminology, CPT, ICD-10-CM, and HCPCS coding.
* Experience with insurance follow-up, denial management, and appeals.
* Familiarity with Medicare, Medicaid, commercial insurance plans, and prior authorization processes.
* Proficiency with EMR and practice management systems.
* Strong analytical, organizational, and problem-solving skills.
* Excellent verbal and written communication skills.

Preferred Experience

* Experience billing for allergy testing, immunotherapy, biologic injections, and respiratory-related procedures.
* Understanding of payer-specific reimbursement policies for allergy and asthma services.
* Certified Professional Biller (CPB) or related certification is a plus.

Key Competencies

* Attention to detail
* Time management
* Critical thinking
* Customer service
* Team collaboration
* Revenue cycle management expertise

Work Environment

* Fully remote/work-from-home position.
* Requires a dedicated, secure, and distraction-free workspace.
* Reliable high-speed internet connection required.
* Regular use of computer, headset, and telephone systems.
* Ability to maintain confidentiality and comply with HIPAA requirements while working remotely.
* Must be able to manage workload independently while collaborating effectively with a remote team.

Performance Expectations:

* Maintain timely follow-up on assigned accounts receivable.
* Achieve collection and productivity targets.
* Reduce claim denials and improve reimbursement turnaround times.
* Ensure accurate and compliant billing practices.

Work Schedule: Monday through Friday, 8:00 a.m. to 4:30 p.m. Pacific Time (PT).

Candidates must be available to work this schedule consistently.

Physical Requirements

Ability to stand, walk, and move throughout the clinic, if applicable, for extended periods; occasionally lift objects up to 25 lbs., bend, stoop, or reach as needed. Frequent use of hands and fingers for patient care and equipment operation. Must have normal (or corrected) vision and hearing and be able to respond quickly in a fast-paced clinical environment, if applicable.

What We Offer

* Competitive compensation and professional development opportunities. Full-time employees are eligible for Modena Health’s benefits package, which includes medical, dental, and vision insurance, as well as a 401(k) retirement plan with employer matching.
* Paid time off (PTO), sick time, floating holidays, and holiday pay are also available to eligible full-time employees in accordance with company policy.

* Opportunity to shape the future of a thriving allergy and asthma practice in beautiful San Diego (and across our expanding network)
* A supportive, mission-focused culture where your contributions directly impact patient outcomes and team growth

If this role excites you, please submit your resume and a cover letter outlining your relevant experience and why you’re passionate about joining our team. We look forward to hearing from enthusiastic candidates ready to drive our success!

California Consumer Privacy Act (CCPA) Notice
Modena Health (“MH”) and Modena Allergy & Asthma ("MAA") complies with the California Consumer Privacy Act (“CCPA”). Personal information provided in the job application process will be collected, used, and retained in accordance with applicable privacy laws. Candidates may request additional information regarding the categories of personal information collected and the purposes for which it is used during the hiring process.