Medical Billing Specialist
- Carlsbad, CA
- $21.50-28.50 per hour
- Permanent
- Full-time
- Prepares and reviews Durable Medical Equipment, Prosthetics/Orthotics & Supplies (DMEPOS) claims for accuracy, completeness, and obtains any missing information prior to finalization of claim for submission.
- Verifies correct payor selection.
- Checks eligibility and verifies benefits for products dispensed.
- Utilizes insurance carrier portals for eligibility and claims information.
- Obtains authorization and pre-authorization as required.
- Works in conjunction with the Health Information Management (HIM) department to ensure submission of clean claims.
- Answers questions from patients, clerical staff, and insurance companies.
- Uses knowledge of standard medical terminology, basic human anatomy, and orthopedic diagnoses ICD-10 codes.
- Resubmits claims to insurance companies as necessary.
- Reviews denial trends to understand issues and corrective actions.
- Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
- Assists in development and communication of SOPs for key areas to improve accuracy and understanding of processes.
- Achieves team goals while demonstrating organizational values and utilizing resources responsibly.
- Meets daily, weekly, and monthly objectives including claim processing, revenue, and achievement of scorecard expectations.
- Cross trains within the billing department to provide coverage when necessary.
- Promotes Breg’s culture of accountability by demonstrating and exemplifying Breg’s cultural beliefs.
- Supports all other medical billing and collection tasks as required.
- Collaborate with cross-functional teams to drive excellence in patient care and business solutions.
- High School diploma or equivalent required.
- A minimum of 1+ years of recent experience in medical billing required.
- A minimum of 2+ years of recent Workers' Compensation billing required.
- Experience with a variety of payor groups required
- Knowledge of CPT, ICD-10, and HCPCS coding and insurance billing rules.
- Proficient in Microsoft Excel, Word, and electronic e-mail systems.
- Ability to work in a fast-paced environment while remaining calm and professional.
- Ability to maintain consistent, regular attendance and punctuality.
- Proficient in computers and relevant software application and practice management technology.
- Possession of strong problem-solving skills and sound judgement.
- Excellent organizational skills and ability to multitask.
- Exhibits high level of quality through attention to detail and monitoring of work.
- Excellent verbal and written communication skills, as well as exceptional interpersonal communication skills.
- A passion for innovation and a commitment to Breg’s mission to Keep Moving Forward.
- Comprehensive Benefits: Medical, dental, vision, disability, and life insurance, effective the first of the month after hire.
- Work-Life Balance: Paid Time Off (PTO) and company-paid holidays.
- Growth & Development: Opportunities for professional advancement within a company that values your contributions.
- Commitment to Diversity & Inclusion: Breg is proud to be an Equal Employment Opportunity employer, fostering a diverse and inclusive workplace.
- For more information regarding Company benefits, please see
- May include variable start/end times outside of the company’s standard business hours of 8:00 a.m. – 5:00 p.m.