Job DescriptionJob Title: Medical Biller / Authorization & Administrative Support
nExperience Level: 2+ Years
nLocation: Vadodara, Gujarat, India / WFH
nShift Time: US Shift (10-hour shift including a 1-hour break)
nExperience Required
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- Minimum 2+ years of hands-on experience in medical billing, preferably within Medi-Cal managed care, behavioral health, or social services billing.n
- Hands-on experience with Office Ally for claims submission, eligibility verification, and ERA/EOB retrieval is strongly preferred.n
- Experience billing to IEHP or California Medi-Cal managed care plans will be an added advantage.n
- Familiarity with CalAIM Community Supports, including HTNS, HTSS, or similar services, is preferred.n

nKey Responsibilities
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- Prepare, review, and submit HTNS and HTSS claims through the Office Ally clearinghouse, ensuring accurate coding, units, authorization numbers, and member eligibility.n
- Monitor clearinghouse reports daily to identify claim acceptance, rejections, and required corrections.n




- Track claims from submission through adjudication and follow up on pending, denied, or underpaid claims.n
- Reconcile remittance advices (835s/EOBs) against expected reimbursement and accurately post payments and adjustments.n
- Research and resolve claim denials by identifying root causes such as authorization mismatches, eligibility gaps, and coding errors.n
- Maintain and update reauthorization trackers to ensure services are billed within active authorization periods.n
- Verify member Medi-Cal/IEHP eligibility prior to billing and flag discrepancies to the appropriate internal team.n
- Maintain accurate, organized, and audit-ready billing records in compliance with HIPAA and applicable privacy requirements.n
- Prepare weekly and monthly billing reports covering aging claims, denial trends, and collections.n
- Stay updated on IEHP authorization guidelines, CalAIM billing requirements, and Office Ally system updates.n
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📌 Medical Biller (Mandvi)
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