Job Title: Medical Biller / Authorization & Administrative Support

Experience Level: 2+ Years

Location: Vadodara, Gujarat, India / WFH

Shift Time: US Shift (10-hour shift including a 1-hour break)

Experience Required

- Minimum 2+ years of hands-on experience in medical billing, preferably within Medi-Cal managed care, behavioral health, or social services billing. - Hands-on experience with Office Ally for claims submission, eligibility verification, and ERA/EOB retrieval is strongly preferred. - Experience billing to IEHP or California Medi-Cal managed care plans will be an added advantage. - Familiarity with CalAIM Community Supports, including HTNS, HTSS, or similar services, is preferred.

Key Responsibilities

- Prepare, review, and submit HTNS and HTSS claims through the Office Ally clearinghouse, ensuring accurate coding, units, authorization numbers, and member eligibility. - Monitor clearinghouse reports daily to identify claim acceptance, rejections, and required corrections. - Track claims from submission through adjudication and follow up on pending, denied, or underpaid claims. - Reconcile remittance advices (835s/EOBs) against expected reimbursement and accurately post payments and adjustments. - Research and resolve claim denials by identifying root causes such as authorization mismatches, eligibility gaps, and coding errors. - Maintain and update reauthorization trackers to ensure services are billed within active authorization periods. - Verify member Medi-Cal/IEHP eligibility prior to billing and flag discrepancies to the appropriate internal team. - Maintain accurate,



organized, and audit-ready billing records in compliance with HIPAA and applicable privacy requirements. - Prepare weekly and monthly billing reports covering aging claims, denial trends, and collections. - Stay updated on IEHP authorization guidelines, CalAIM billing requirements, and Office Ally system updates. - Collaborate with internal teams to resolve documentation and authorization issues affecting billing.

Authorization & Administrative Support

- Monitor and process incoming faxes on a daily basis. - Access the IEHP provider portal to retrieve new authorizations. - Enter and update authorization numbers accurately in the relevant tracking systems. - Save authorization documents and related files in the designated shared drive according to filing standards. - Assign current members and authorizations to the appropriate Case Manager. - Review the reauthorization tracker regularly with the supervisor and ensure timely follow-up. - Submit completed and supervisor-approved reauthorization requests through the IEHP provider portal. - Maintain accurate documentation and complete administrative activities in a timely and organized manner.

Required Knowledge & Skills





- Strong understanding of the medical billing and revenue cycle process. - Working knowledge of Medi-Cal managed care billing and IEHP processes. - Hands-on knowledge of Office Ally for claims processing and eligibility verification. - Understanding of claims submission, rejection management, denial follow-up, payment posting, and reconciliation. - Knowledge of HIPAA privacy and security requirements and ability to handle PHI appropriately. - Strong Excel skills for claim tracking, payment reconciliation, and reporting. - Excellent attention to detail and strong organizational skills. - Ability to manage high-volume billing activities while maintaining accuracy. - Strong written and verbal communication skills for communication with payer representatives and internal teams.

Preferred Qualifications

- High school diploma or equivalent required; Associate's degree or medical billing/coding certification preferred. - Certified Professional Biller (CPB) or similar billing certification is an added advantage. - Experience with Google Workspace (Sheets, Drive) in a HIPAA-compliant environment. - Experience with claims scrubbing, denial management workflows, or revenue cycle management software. - Experience with behavioral health, community support, or social services billing is preferred. - Ability to work independently with minimal supervision while maintaining productivity, accuracy, and compliance.

Interested candidates can share their CV at [email protected].

📌 Medical Biller (Vadodara)
🏢 Office Beacon
📍 Vadodara