Job Summary Required Qualifications and Skills
We are seeking an experienced Sr. Biller and Coder for a direct hire opportunity in San Leandro, CA. This role is ideal for a senior revenue cycle professional with strong Medi-Cal billing expertise, advanced coding knowledge, and a proven ability to improve claims accuracy, reduce denials, and support timely reimbursement.
This position offers the opportunity to join a mission-driven nonprofit healthcare environment where accuracy, compliance, teamwork, and community impact matter. The Sr. Biller and Coder will work closely with providers, clinical teams, and billing staff in a collaborative setting with supportive leadership, opportunities to mentor others, and a clear focus on quality patient care and financial performance.
Key Responsibilities
- Assign accurate ICD-10-CM, CPT, and HCPCS codes based on provider documentation and payer requirements.
- Submit and manage electronic and paper claims for Medi-Cal, managed Medi-Cal plans, Medicare, commercial carriers, and other payers.
- Monitor claim status, resolve denials and rejections, appeal underpaid claims, and support maximum compliant reimbursement.
- Reconcile payments, adjustments, accounts receivable balances, and aging reports to prioritize collection efforts.
- Partner with providers and clinical staff to improve documentation accuracy, coding compliance, and revenue cycle outcomes.
- Train and mentor billing and coding staff while assisting with audits, month-end reporting, productivity metrics, and revenue cycle analysis.
Compensation and Benefits
- Pay range: $31.00 to $33.00 per hour.
- Job type: Direct hire.
- Location: San Leandro, CA.
- Manage coding, billing, claims submission, denial resolution, payment posting, and accounts receivable follow-up.
- Review medical documentation for accuracy, compliance, and payer-specific billing requirements.
- Support Medi-Cal reimbursement processes, appeals, audits, and revenue cycle reporting.
- Collaborate with providers, clinical teams, internal departments, payers, and patients to resolve billing inquiries.
- High school diploma or equivalent required.
- Minimum 5 years of medical billing and coding experience, including at least 3 years processing Medi-Cal claims.
- Extensive knowledge of California Medi-Cal billing requirements, managed Medi-Cal plans, and reimbursement methodologies.
- Proficiency with ICD-10-CM, CPT, and HCPCS coding systems.
- Experience using electronic health records and practice management software.
- Strong understanding of revenue cycle management, claims processing, payment posting, and accounts receivable follow-up.
- Proven experience resolving denials and preparing successful claim appeals.
- Knowledge of HIPAA privacy and security requirements.
- Excellent analytical, organizational, problem-solving, communication, and customer service skills.
- Ability to work independently, manage multiple priorities, meet deadlines, and maintain a high level of accuracy.
Preferred Qualifications
- Associate degree in Health Information Management, Medical Billing, or a related field.
- Certified Professional Coder, Certified Coding Specialist, or Certified Professional Biller certification.
- Experience with Federally Qualified Health Centers, community health centers, behavioral health, or multi-specialty practices.
- Experience with managed care contracts and payer credentialing.
- Knowledge of Medicare, Medicaid, and commercial insurance billing regulations.
Equal Opportunity Employer / Disabled / Protected Veterans
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For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.
We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.
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We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.