Medical Billing & Revenue Cycle Specialist — Primary Care / Office Ally

Company: Coral Med Primary Care
Schedule: Part-time initially, with potential to expand to full-time
Compensation: Starting at $5 USD/hour, with review based on demonstrated skills and performance
Availability: Consistent overlap with California business hours required

About us

Coral Med Primary Care is an independent, physician-owned primary care practice in Huntington Beach, California.

We are seeking an experienced medical billing specialist who understands the full revenue cycle—from insurance verification through final payment and account reconciliation. We need someone organized, proactive, and capable of resolving problems with minimal day-to-day direction.

About the role

Initially, you will review work performed by our existing billing company, reconcile encounters and claims, maintain our billing tracker, and work assigned unpaid or denied claims.

As you demonstrate accuracy and independence, you may assume responsibility for the practice’s full billing cycle. You must be comfortable both reviewing another team’s work and performing the billing yourself.

Responsibilities

• Verify insurance eligibility, benefits, network status, HMO PCP/IPA assignment, and primary/secondary payer order.
• Identify referral and prior authorization requirements and coordinate resolution with office staff.
• Reconcile completed appointments with charges and claims to identify missing or unbilled services.
• Review CPT/HCPCS codes, ICD-10 diagnoses, modifiers, units, and diagnosis links; request physician clarification when needed.
• Prepare and submit claims to the correct payer, IPA, or administrator.
• Use Office Ally and payer portals to confirm clearinghouse acceptance and payer receipt.
• Correct rejected claims and track them through successful acceptance.
• Read EOBs/ERAs and accurately post payments, contractual adjustments, and patient responsibility.
• Review payments for underpayments, missing service lines, and unexplained adjustments.
• Investigate denials, prepare corrected claims or appeals, submit required documentation, and follow through to resolution.
• Bill secondary insurance and verify crossover receipt and payment.
• Work aging accounts receivable and track filing, correction, and appeal deadlines.
• Create accurate, printable patient statements for mailing and explain balances clearly.
• Reconcile payments with EFTs/checks, investigate credit balances and recoupments, and coordinate refunds under practice policy.
• Maintain our billing spreadsheet and provide concise weekly reports on outstanding claims, denials, recoveries, and issues requiring action.
• Help develop clear billing SOPs and prevent recurring errors.

Required qualifications

• At least 3 years of hands-on U.S. medical billing experience
• Experience across the full revenue cycle, including claim submission, payment posting, denial resolution, and A/R follow-up.
• Ability to explain which billing functions you have personally performed.
• Experience with Medicare and commercial insurance.
• Familiarity with clearinghouses, payer portals, EOBs/ERAs, and primary/secondary billing.
• Strong written and spoken English.
• Strong spreadsheet skills using Excel or Google Sheets.
• Reliable internet, a backup connectivity/power plan, and a private workspace.
• Ability to handle confidential patient information and follow practice privacy and security requirements.

*HIPPA compliance training

• Ability to work independently, identify and resolve billing issues, manage follow-up deadlines, and escalate questions appropriately.
• OnlineJobs.ph ID Proof score of 80 or higher; 90+ preferred.

Preferred qualifications

• Office Ally EHR/Practice Mate and clearinghouse experience.
• Primary care or internal medicine billing experience.
• Experience with California HMO/IPA arrangements, capitation, encounter submissions, and FFS carve-outs.
• Experience with Regal Medical Group, ADOC, or similar IPAs.
• Familiarity with Medicare preventive services, procedures, injections, and care-management billing.
• Experience creating reports, training materials, or billing SOPs.
• Five or more years of relevant experience.
• Ability to create, document, and improve step-by-step SOPs for the full revenue cycle, including insurance verification, claim submission, payment posting, denial management, A/R follow-up, and patient billing.

What success looks like

You can account for every completed encounter, confirm claims reached the correct payer, identify why a claim remains unpaid, take the appropriate action, and maintain a clear follow-up plan.

We value accurate resolution and reliable reporting—not simply marking claims “submitted” or “resubmitted.”

How to apply

Please use the application subject:

“Coral Med Billing — Full Cycle”

Include:

1. Your résumé and OnlineJobs.ph profile link.
2. Your years of U.S. billing experience and the specialties you have supported.
3. The billing systems, clearinghouses, and payer portals you have personally used.
4. Your experience with Office Ally, Medicare, HMO/IPA billing, capitation, and secondary insurance.
5. One example of a denied or unpaid claim you personally resolved: the problem, actions taken, and outcome. Do not include patient-identifying information.
6. Which full-cycle billing responsibilities you can perform independently and which would require training.
7. Your available hours, California business-hour overlap, earliest start date, and current work commitments.
8. Your internet connection and backup arrangements.
9. A link to a 1–2-minute introductory video describing your relevant experience.
10. A brief answer to this scenario:
“A claim was submitted 45 days ago, but no payment or EOB has been received. What would you check, and what would you do next?”

Please use at least 7 Apply Points when applying.

Shortlisted candidates will complete an interview and may require a paid practical assessment using fictional or de-identified billing examples. Finalists may be asked for professional references. The role will begin with a 30-day paid trial.