Medical Billing Specialist

A client of Insight Global is seeking a Medical Billing Specialist to join our team in Carlsbad, CA. If you thrive in a dynamic environment where innovation and impact go hand in hand, this is the opportunity for you. This company is dedicated to advancing orthopedic solutions that enhance the lives of patients and support healthcare professionals. As a leader in the orthopedic industry, they provide innovative products, consulting, technology, and services that help people move forward with confidence.

In your day-to-day role, you prepare and review DMEPOS (Durable Medical Equipment, Prosthetics/Orthotics & Supplies) claims to ensure they’re accurate and complete, gathering any missing information before finalizing them for submission. You verify the correct payor selection, check patient eligibility, and confirm benefits for the products dispensed using insurance carrier portals. You obtain authorizations and pre-authorizations as needed, and work closely with the Health Information Management (HIM) department to ensure clean claim submissions. You respond to questions from patients, clerical staff, and insurance companies, applying your knowledge of medical terminology, basic human anatomy, and ICD-10 orthopedic diagnosis codes. You resubmit claims when necessary, analyze denial trends to identify issues and corrective actions, and maintain strict confidentiality in line with HIPAA regulations. You help develop and communicate SOPs to improve process accuracy and understanding, meet daily, weekly, and monthly goals related to claim processing and revenue, and support scorecard expectations. You cross-train within the billing department to provide coverage when needed, promote Breg’s culture of accountability, and assist with other billing and collection tasks. You also collaborate with cross-functional teams to enhance patient care and drive business solutions.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.

•High school diploma or GED
•1+ years’ experience in medical billing
•Experience with a variety of payor groups (like:
•Knowledge of CPT, ICD-10, and HCPCS coding and insurance billing rules.
•Proficient in Microsoft Excel, Word, and electronic e-mail systems.

•2+ years’ experience in workers compensation billing
•Collections Experience

Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.