Medical Billing Representative

3 months ago


San Diego, United States San Diego Cardiac Center Medical Group Inc Full time
Job DescriptionJob Description

SUMMARY OF POSITION:

The Medical Billing Representative will be responsible for miscellaneous daily functions in the medical billing office. Reliability with high attention to detail and organizational skills is needed for this position. The ideal candidate is someone who takes pride in their everyday tasks, can function effectively as part of a team, as well as being able to work independently.

PRIMARY DUTIES AND RESPONSIBILITIES: The primary job functions required of our Medical Billing Representative includes the following, but not limited to:

  • Thorough appropriate account review on billed claims, contact third-party payors for status and resolution
  • Requests additional information from physician offices, patients, and others as needed to resolve payor requests
  • Identify billing or coding issues and request re-bills, secondary billing, or corrected bills as needed
  • Updates patient demographics as needed and correct plan IDs
  • Posts appropriate follow-up notes/status to accounts
  • Written appeals and corrections to third-party payors as needed
  • Recognizes repetitive errors and delays with payors and escalates payment delays/ problems accounts timely to manager
  • Perform collection efforts on delinquent patient accounts
  • Perform special projects and other duties as needed
  • Ensures compliance with State and Federal Laws Regulations
  • Maintain the strictest confidentiality; adhere to all HIPAA guidelines/regulations

OTHER MISCELLANEOUS AND RELATED TASKS

  • Assist other Billing Representatives and Management with a variety of other daily tasks
  • Respond to email, EHR messages/tasks throughout the day
  • Be a team player: Identify how you might assist fellow team members
  • Always represent SDCC and its staff and Providers in a professional, courteous, and respectful manner on or off the property

CORE COMPENTENCIES AND EXPECTATIONS: A successful Medical Billing Representative will possess the necessary core competencies and meet the general expectations, such as:

  • Thorough understanding of the revenue cycle process for physician billing
  • Possess intermediate skills in Microsoft Office (Word, Excel)
  • Ability to learn billing systems
  • Ability to communicate in a clear and professional manner
  • Must possess good oral and written skills
  • Strong interpersonal skills
  • Ability to make sound decisions
  • Familiar with terms such as HMO, PPO, IPA and Capitation
  • Understanding/ability to read an EOB
  • Intermediate understanding of HCFA 1500 forms.
  • Ability to problem solve, prioritize duties and follow through completely with assigned tasks.

POSITION REQUIREMENTS

  • 2-3 years of medical claims and/or collections experience
  • Cardiology experience preferred

POSITION SPECIFICS

  • Full time
  • Monday-Friday
  • 7:30 am to 4:30 pm


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