Job: Insurance Biller ll

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Posted: 09/19/2017

Job Status: Full Time

Job Reference #: 588338

Job Description

  • Job Tracking ID: 512329-588338
  • Job Location: Escondido, CA
  • Job Level: Any
  • Level of Education: Any
  • Job Type: Full-Time/Regular
  • Date Updated: August 22, 2017
  • Years of Experience: Any
  • Starting Date: ASAP

Job Description:

Summary: Under the direction of the Billing Supervisor, the Insurance Biller-Level II is responsible for all computerized and manual billing to patients and third parties, including Medi-Cal, CHDP, Medicare, private insurances, FamPact, Managed Care plans, and various programs and funding sources as assigned. Responsible for correct coding processes and compliance measures as set by the organization, department, and industry.

Essential Duties/Responsibilities:

  1. Review of encounters for missing, incomplete, and/or inaccurate information such as coding discrepancies, payer HEDIS needs, eligibility screening and coverage verification as necessary, etc. Review of progress notes and communication to clinical staff to obtain information required.
  2. Claim creation for all billable charges as assigned, with submission of clean claims in compliance with correct coding initiatives and billing industry requirement.
  3. Processing and monitoring of system claim status categories assigned to be sure that all transactions are captured for month end close.
  4. Register patients as needed.
  5. Able to review and process patient eligibility with accuracy, to include acquisition of authorization numbers as necessary.
  6. Apply SFS discounts as necessary.
  7. Posting of payments as necessary.
  8. Account balance adjustments and write offs to resolve accounts as assigned.
  9. Monitoring and reporting of trends associated with denials, coding issues, benefit changes, etc…
  10. Review and processing of claims aging and denials as assigned to include claim tracers, corrected claim submissions, appeals, and consistent revenue flow.
  11. Responsible for back-line phone calls from sites and voicemail associated on a daily basis.
  12. Discuss escalated billing inquiries with patients, third party payers, and/or sites to resolve account questions and/or problems.
  13. Provide customer service internally and externally with professionalism, courtesy, knowledge, and follow through.
  14. Handle Site/Insurance/Patient correspondence, as assigned, received in the department with a sense of urgency and appropriate follow through.
  15. Maintaining department productivity, quality, and compliance standards at all times.
  16. Attend educational workshops, staff meetings and clinic in-services as directed.
  17. Function at highest level according to credentials and competency
  18. Other duties/projects as assigned.

Experience and Skills:

Abilities: Able to demonstrate proficient knowledge on use of CPT, HCPCS and ICD codes; familiarity with insurance payers and funding sources to include manage care plans. Ability to appeal underpaid and/or denied claims effectively. Should be proficient with MS Office (Word, Excel, and Outlook).

Skills: Attention to detail and accuracy; motivated self-starter; Enthusiastic, Ability to work efficiently in a fast paced environment and follow through on processes; critical thinking skills to assess and resolve complex patient account; excellent customer service skills required and ability to handle difficult situations.

Bilingual (English/Spanish) preferred.

Education: High School Diploma / GED.

Experience: Must have a minimum of 2 years of medical billing and follow-up experience with a well-rounded understanding of the revenue cycle process. Multiple specialty and/or FQHC environment experience a plus.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

Apply Online

Locations

Date Clinic
425 N. Date Street
Escondido, CA 92025
Date Dental Clinic
425 North Date Street
Escondido, CA 92025
El Cajon
855 E. Madison Ave.
El Cajon, CA 92020
Elm Clinic
460 N. Elm St.
Escondido, CA 92025
Grand Clinic
1001 E. Grand Ave
Escondido, CA 92025
Hemet, CA
-
Hemet, CA 92544
Ivy
401 E. Valley Pkwy.
Escondido, CA 92025
Lakeside Clinic
10039 Vine St.
Lakeside, CA 92040
MHS
Misson Avenue
Escondido, CA 92025
Palomar Medical Center - Hospitalist
425 N. Date
Escondido, CA 92025
Pauma Valley Clinic
16650 Highway 76, PO Box 655
Pauma Valley, CA 92061
Pediatrics & Prenatal Clinic
426 N Date St.
Escondido, CA 92025
Sun City
26926-B Cherry Hills Blvd.
Menifee, CA 92584
Temecula
41715 Winchester Rd., Suite 106
Temecula, CA 92590
Valley Parkway Clinic
728 East Valley Parkway
Escondido, CA 92025
Not Specified
-
Not Specified, NS 99997
Date Clinic
Date Dental Clinic
El Cajon
Elm Clinic
Grand Clinic
Hemet, CA
Ivy
Lakeside Clinic
MHS
Palomar Medical Center - Hospitalist
Pauma Valley Clinic
Pediatrics & Prenatal Clinic
Sun City
Temecula
Valley Parkway Clinic
Not Specified

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