Job Post: Healthcare Billing Specialist (ASC Billing) Position Code: GJ-MHS Position Type: Full-Time (40 hours per week) Work Hours: 9:00 AM – 5:00 PM PDT Work Days: Monday to Friday Salary: Starting at $6 - 7 per hour (depending on experience) We are seeking a detail-oriented and experienced Healthcare Billing Specialist specializing in Ambulatory Surgery Center (ASC) billing to support accurate claims processing, efficient revenue cycle management, and timely reimbursement for U.S. healthcare providers. In this role, you will primarily handle ASC medical billing, including surgical claims submission, insurance verification, payer follow-ups, denial management, appeals, and accounts receivable. You will ensure claims are accurately processed according to ASC-specific billing requirements, coding guidelines, and payer policies. The ideal candidate has strong hands-on experience with ASC billing workflows, outpatient surgical procedures, CPT/HCPCS codes, modifiers, and reimbursement processes. Experience with home health billing, Notices of Admission (NOAs), and ALORA software is an added advantage. Beyond billing responsibilities, you will also provide administrative, executive, and patient communication support to help maintain efficient daily operations. If you are a proactive medical billing professional who enjoys resolving complex claims, improving reimbursement outcomes, and supporting healthcare providers, we'd love to hear from you! Key Responsibilities ASC Billing & Revenue Cycle Management (Top Priority) • Manage full-cycle Ambulatory Surgery Center (ASC) billing, including claims preparation, submission, tracking, follow-ups, denials, appeals, and reimbursement resolution. • Prepare, review, and submit claims for outpatient surgical procedures, ensuring accuracy and compliance with payer requirements. • Apply knowledge of ASC-specific CPT/HCPCS codes, modifiers, and billing guidelines to identify potential claim errors. • Verify that surgical claims include accurate procedure information, appropriate modifiers, and required supporting documentation. • Navigate Medicare, Medicaid, and commercial insurance billing requirements applicable to ASC services. • Review payer-specific reimbursement guidelines, including applicable ASC payment methodologies. • Investigate rejected, denied, underpaid, or unpaid surgical claims and determine appropriate corrective actions. • Process corrected claims, reconsiderations, and appeals to resolve reimbursement discrepancies. • Manage accounts receivable (AR) and follow up on outstanding ASC claims. • Identify coding-related discrepancies, missing documentation, and potential reimbursement issues. • Verify patient insurance eligibility, coverage, and benefits before claim submission when needed. • Coordinate with insurance representatives and internal teams to resolve billing concerns. • Ensure claims are accurate, complete, and compliant with applicable payer requirements. • Meet the daily productivity target of 45 claim follow-ups per day. • Upload, track, organize, and maintain Explanation of Benefits (EOBs). • Maintain accurate records of submitted, pending, denied, corrected, and resolved claims. Home Health Billing Support • Assist with home health agency billing and revenue cycle management as needed. • Review and process Notices of Admission (NOAs) for accuracy, completeness, and timely submission. • Support home health claims submission, insurance follow-ups, and denial resolution. • Utilize ALORA for billing, documentation, and claim tracking when applicable. • Ensure home health billing activities follow applicable payer requirements. • Maintain accurate documentation and records of home health billing activities. Administrative & Executive Support • Prepare and maintain billing reports, spreadsheets, claims trackers, and documentation. • Assist with administrative overflow and other operational responsibilities. • Provide executive and administrative support to ensure smooth daily operations. • Maintain organized records and communicate outstanding tasks or concerns promptly. • Support workflow improvements to increase billing efficiency and accuracy. Patient Communication & Reception Support • Answer and manage inbound and outbound calls using Nextiva VoIP. • Respond to patient inquiries professionally, accurately, and promptly. • Provide receptionist-level support when needed. • Communicate with patients, insurance representatives, and internal staff regarding billing-related inquiries. • Maintain patient confidentiality and provide professional, empathetic communication. Top 3 Priorities 1. Accurate ASC Claims Processing & Submission Ensure outpatient surgical claims are prepared and submitted accurately using appropriate CPT/HCPCS codes, modifiers, supporting documentation, and payer-specific billing requirements. 2. ASC Denial Management, Accounts Receivable & Reimbursement Proactively manage outstanding surgical claims, denials, rejections, underpayments, and appeals. Conduct consistent payer follow-ups while meeting the daily target of 45 claim follow-ups to support timely reimbursement. 3. Billing Compliance, Documentation & Operational Support Maintain accurate billing records, follow ASC-specific payer requirements, identify documentation discrepancies, and support administrative operations while ensuring HIPAA compliance. What Success Looks Like A successful Healthcare Billing Specialist consistently demonstrates: • Accurate and timely ASC claims submission. • Strong knowledge of outpatient surgical billing requirements. • Effective resolution of denied, rejected, and underpaid ASC claims. • Consistent management of accounts receivable and outstanding reimbursements. • Achievement of the daily KPI of 45 claim follow-ups. • Accurate application of relevant CPT/HCPCS codes, modifiers, and payer requirements. • Organized and complete EOB documentation and claims tracking. • Proactive identification of billing errors and reimb