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FTE
1
Scheduled Bi-Weekly Hours
80
Work Shift
Day: 8 hours
Job Description
Unit Specific Duties Listed Below
Billing
- Ensures claims are billed timely and accurately using the Hospital Claims Scrubber Tool and billing system. Resolves claim edits.
- Collaborates with departments to resolve applicable claim errors.
- Reports all unbilled claim information and issues that may delay billing to Management to ensure there is no adverse effect on Hospital Cash Collections or Accounts Receivable.
Customer Service
- Receives and processes correspondence and phone or online inquiries from patients, payers or any other third party in a timely and professional manner.
- Resolves patient billing inquiries and processes patient payments over the phone or in person.
Follow Up
- Follows up on unpaid and denied claims for account resolution.
- Resolves accounts by contacting managed care entities, other third party payer organizations or patients to facilitate timely payments.
- Performs research and makes determination of appropriate actions for payment resolution. Writes and submits appeals for denied claims.
- Keeps informed of managed care and contractual arrangements to resolve accounts by managed care payers.
- Assigns root causes to denials based on research.
Payment Posting
- Posts daily cash and adjustments for Hospital and Professional billing.
- Resolves undistributed payments and performs cash reconciliation.
- Reports all payment issues to Management to ensure there is no adverse effect on Hospital Cash Collections or Accounts Receivable.
Self Pay Credit Balances
- Resolves credit balances that are due to patients.
- Audits and reconciles accounts to confirm credit balance and submits refunds in a timely manner.
Qualifications
- High School Diploma or equivalent.
- One year related work experience in a Hospital, Physician, or other healthcare setting.
- Strong verbal and written communication skills.
- Works in a collaborative and team manner.
- Efficient organizational skills and effective reasoning, problem solving and critical thinking skills.
- Excellent typing skills.
- Ability to multi-task and demonstrate effective time management.
- Preferred knowledge and use of Microsoft Products: Outlook, Word & Excel.
- Strong attention to detail.
- Ability to process a high volume of work.
Unit Specific Qualifications
Billing
- Knowledge of medical terminology and billing.
- Prior experience with facility billing or a similar role.
- Understands Medicare, Medi-Cal, HMO, PPO and 3rd party rules and regulations.
Customer Service
- Prior experience in a customer service setting.
- Preferred knowledge of health insurance coverages.
Follow Up
- Experience with claim processing and denial follow up and resolution.
- Knowledge of insurance appeal writing.
- Basic knowledge of contracting.
- Understands Medicare, Medi-Cal, HMO, PPO and 3rd party rules and regulations.
Payment Posting
- Preferred cash and adjustment posting background with regards to quality control of payments and transactions to financial system.
- 10-key preferred.
Self Pay Credit Balances
- 10-key preferred.
- Knowledge of basic accounting practices and procedures.
License/Certification/Registration Requirements
None required
Ages of Patients Served
This position will serve all age groups.
Salary Range:
$33.75 - $50.63 USD Hour
The Physical Requirements and Working Conditions of this job are available. El Camino Health will provide reasonable accommodations to qualified individuals with a disability if that will allow them to perform the essential functions of a job unless doing so creates an undue hardship for the hospital, or causes a direct threat to these individuals or others in the workplace which cannot be eliminated by reasonable accommodation.
Sedentary Work - Duties performed mostly while sitting; walking and standing at times. Occasionally lift or carry up to 10 lbs. Uses hands and fingers. - (Physical Requirements-United States of America)
