Job Description
Raincross Medical Group | Riverside, CA Raincross Medical Group is seeking a detail-oriented Medical Billing Specialist with at least one year of medical billing experience , including claim denials, billing reports, and audits. Responsibilities Review and resolve denied or rejected claims, including corrected claims and appeals. Follow up on unpaid claims and outstanding insurance balances. Prepare and review billing reports to identify discrepancies and follow-up needs. Conduct billing audits…
7:30 AM
Log in and pull the overnight denial queue. Your worklist shows 40–80 claims flagged by the payer in the last 24 hours. Sort by do…
8:00 AM
Start working the queue. For each denial, you're reading the remittance advice, identifying the denial reason code (CO-4, CO-50, C…
9:30 AM
Hit a complex medical necessity denial from a Medicare Advantage plan. Open the patient chart, pull the clinical documentation, an…
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