3 medical biller claims processing jobs found in San Diego

Patient Support Medical Claims Processing Representative Contract Remote Role Location (Open to Remote US) As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma, medical device and diagnostic companies get their therapies to the people who need them. We help customers gain insight and access to their markets and ultimately demonstrate their product's value to payers, physicians, and patients. A significant part of our business is providing patient support programs on the behalf of our customers. With the right experience, you can help provide support to patients in need of available therapies. IQVIA has the world's largest Commercial Sales & Medical Solutions (CSMS) organization dedicated to the launch and marketing of pharmaceutical and medical products. With a focus on providing talent for patient support, field/inside sales, medical device support, clinical support, and...

Job Description Job Description Benefits: 401(k) Dental insurance Health insurance Paid time off Vision insurance Benefits/Perks Competitive Compensation Great Work Environment Career Advancement Opportunities Job Summary We are currently seeking a detail-oriented and dedicated Medical Biller to join our team. In this role, you will be responsible for managing the billing and collection of outstanding account balances for Medi-Cal and managed care payors . You will analyze and interpret complex payor contract language to calculate expected reimbursements accurately and ensure timely collection of all payments owed to the organization. Responsibilities Process medical billing and follow up on claims with Medi-Cal and managed care payors Audit and evaluate clinical documentation and billing records to ensure they are accurate, timely, clinically appropriate, justify medical necessity for Medi-Cal reimbursement, and comply with all State and County...

Job Description Job Description Summary The Medical Biller for Cal AIM Services is responsible for accurately billing and processing claims for Enhanced Care Management (ECM), Recuperative Care, Community Supports (CS), detox billing, and other Cal AIM-related services. This role ensures timely claim submission, compliance with DHCS and Managed Care Plan (MCP) requirements, and effective coordination with clinical, administrative, and data teams to support revenue integrity. Essential Functions Prepare, submit, and track claims for ECM, Recuperative Care, Community Supports, detox billing, and other Cal AIM service lines. Verify eligibility and authorization requirements for all Cal AIM beneficiaries. Ensure documentation meets Cal AIM billing standards, including encounter data, activity logs, and service notes. Reconcile encounters and claims to identify discrepancies or missing documentation. Process claims corrections, resubmissions, and voids as needed....