Billing & Collections Representative II - PFS - RCSSD

3 weeks ago


San Diego, United States Rady Children's Hospital-San Diego Full time

JOB SUMMARY:

Under the direction of the Supervisor Professional Billing & Coding follows Federal State & local regulatory collection guidelines as well as payor specific billing/collection guidelines. Responsible for the collection of outstanding balances from all Commercial HMO PPO Medi-Cal & Managed Care payors professional claims. Responsible for identifying issues checking status of unpaid claims by telephone websites and/or any means available. Responsible for providing information & documentation to ensure timely & accurate reimbursement. Manages & assembles all data & documents required for accurate follow-up of claims. Ability to perform complicated calculations to adjudicate accounts appropriately. Ability to analyze & adjudicate contractual arrangements as determined by agreements entered into by the Medical Practive Foundation. Reviews remittance codes from EOB-s & R/A-s to ensure payment or to identify denials or non-payment. Responsible for follow up with payor on the routing of claims. Refers all payor issues/problems to leadership in a timely manner with specific examples. Responsible for accurate & timely documentation of all follow up pertaining to the resolution of the account within the IS system patient financial record.

Skills Required:

* Strong verbal and written communicator
* Problem-solver
* Master negotiator
* Emotional Intelligence
* Attention to detail

MINIMUM QUALIFICATIONS:

High School Diploma, GED, or Equivalent

3 years of experience

Previous billing experience

The expected hiring range for this position is $22.00 to $30.26

Rady Children's Hospital is committed to compensation that is externally competitive and internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar size in the nonprofit, healthcare sector. The range listed above does not represent the full salary range for the position but is the expected hiring range for qualified candidates. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity. This posting will remain open from the "date posted" until the hiring manager has determined there is a sufficient applicant pool or until the position is filled.



  • San Diego, United States Rady Children's Hospital-San Diego Full time

    JOB SUMMARY: Billing & Collections Rep II-Refunds The overall objective is to process credit balances on accounts. The incumbent will assume responsibility for identifying, researching, analyzing & resolving credit balances on accounts. Incumbent is responsible for working credit balance accounts within an assigned system work queue. Following established...


  • San Diego, California, United States Rady Children's Hospital San Diego Full time

    JOB SUMMARY:Billing & Collections Rep II-Refunds The overall objective is to process credit balances on accounts. The incumbent will assume responsibility for identifying, researching, analyzing & resolving credit balances on accounts. Incumbent is responsible for working credit balance accounts within an assigned system work queue. Following established...


  • San Diego, United States Rady Children's Hospital-San Diego Full time

    JOB SUMMARY: Under the direction of the Supervisor Professional Billing & Coding follows Federal State & local regulatory collection guidelines as well as payor specific billing/collection guidelines. Responsible for the collection of outstanding balances from all Commercial HMO PPO Medi-Cal & Managed Care payors professional claims. Responsible for...


  • San Diego, United States Rady Children's Hospital-San Diego Full time

    JOB SUMMARY: Under the direction of the Supervisor of Professional Billing & Coding, the Billing and Collections Rep receives charge batches for verification and pre-coding. These batches will be received directly from the clinic or hospital care area via the electronic medical record system. Using IS system reports ensures that all expected charges are...


  • San Diego, United States Rady Children's Hospital-San Diego Full time

    JOB SUMMARY: Under the direction of the Supervisor of Professional Billing & Coding, the Billing and Collections Rep receives charge batches for verification and pre-coding. These batches will be received directly from the clinic or hospital care area via the electronic medical record system. Using IS system reports ensures that all expected charges...


  • San Diego, United States Rady Children's Hospital-San Diego Full time

    JOB SUMMARY: Under the direction of the Supervisor Professional Billing & Coding follows Federal State & local regulatory collection guidelines as well as payor specific billing/collection guidelines. Responsible for the collection of outstanding balances from all Commercial HMO PPO Medi-Cal & Managed Care payors professional claims. Responsible for...


  • San Diego, United States Rady Children's Hospital-San Diego Full time

    JOB SUMMARY: Billing & Collections Rep II-Refunds The overall objective is to process credit balances on accounts. The incumbent will assume responsibility for identifying, researching, analyzing & resolving credit balances on accounts. Incumbent is responsible for working credit balance accounts within an assigned system work queue. Following established...

  • Account Analyst Ii

    1 week ago


    San Diego, United States Sharp Healthcare Full time

    [H.S. Diploma or Equivalent **Hours**: **Shift Start Time**: 7 AM **Shift End Time**: 3:30 PM **AWS Hours Requirement**: 8/40 - 8 Hour Shift **Additional Shift Information**: 7am-9am **Weekend Requirements**: As Needed **On-Call Required**: No **Hourly Pay Range (Minimum - Midpoint - Maximum)**: $21.000 - $25.922 - $31.106 **What You Will Do** To...


  • San Diego, United States accurate billing and collections Full time

    Job Summary: **Responsibilities**: - Manage the accounts receivable team, providing guidance and support - Oversee billing processes, ensuring accuracy and timeliness - Monitor accounts to identify outstanding debts and implement collection strategies - Collaborate with internal departments to resolve claim files Qualifications: - Bachelor's degree in...


  • San Leandro, United States A.P.R., Inc. (AlphaProTemps) Full time

    Job DescriptionJob Description* 6 Month contract, may extend* Monday - Friday, 7:00 AM - 3:30 PM* $34.00 per hour Preferred:3-5 years of experience in a hospital business environment performing billing and/or collections.No certification requirement however someone with a strong background in collection and patient accounting (medical billing).EPIC back-end...


  • San Antonio, United States Sigma Full time

    8194068 Patient Financial Representative Senior, San Antonio, TX, 3 Months Contract Sigma Inc. is currently looking forPatient Financial Representative Senior to work onsite in San Antonio, TX. Shift Schedule : M-F, 8 AM to 5 PM, 8 hours/day. Job Summary : The associate is responsible for the duties and services that are of a support nature to the...

  • Branch Manager

    2 weeks ago


    San Antonio, United States PFS Corp Full time

    Do you go above and beyond to motivate and coach a team to achieve goals? Do you enjoy building business relationships that last? Professional Financial Services (PFS) has been purchasing retail installment contracts for new and used automobiles, trucks and motorcycles originated by franchise and independent vehicle dealers since 1995. We have 58 branches in...


  • San Antonio, United States Christus Health Full time

    Job DescriptionSummary:The associate is responsible for the duties and services that are of a support nature to the Revenue Cycle division of CHRISTUS Health. The associate ensures that all processes are performed in a timely and efficient manner. The primary purpose of this position is to ensure account resolution and reconciliation of outstanding balances...


  • San Antonio, United States Staffing Full time

    Job DescriptionJob DescriptionSummaryPatient Financial Representative Senior- OnsiteMonday-Friday 8 hoursLocation updated - 4803 NW Loop 410, , San Antonio, TX, 78229​​No longer require HS/GED verification - Client submission doc should have merged PDF file with Non clinical cover sheet with formatted resume. No need for Education doc​Summary This...


  • San Antonio, United States Carenet Full time

    Overview Are you ready to lead a dynamic team in the finance department of one of the leading healthcare organizations? Carenet Health is seeking a proactive and experienced Billing & Collections Manager to join our team. As the Billing & Collections Manager, you'll have the opportunity to lead a team of talented individuals while implementing best...

  • Contract Specialist

    2 weeks ago


    San Diego, United States tapwage Full time

    JOB SUMMARY: Responsible for seeking contract opportunities, reviewing contract language and terms, conducting data analysis on financial terms, negotiating contracts, and managing executed contracts for all RCHSD entities. Coordinates communication and problem resolutions regarding payment issues with all contracted payors. Manages the contract review...

  • Contract Specialist

    1 week ago


    San Diego, United States Rady Children's Hospital-San Diego Full time

    JOB SUMMARY: Responsible for seeking contract opportunities, reviewing contract language and terms, conducting data analysis on financial terms, negotiating contracts, and managing executed contracts for all RCHSD entities. Coordinates communication and problem resolutions regarding payment issues with all contracted payors. Manages the contract review...


  • San Diego, United States Wheelhouse Credit Union Full time

    Description: **Summary**: The position of Universal Service Representative II is responsible for supporting the Branch Manager and Assistant Branch Manager by ensuring operational and sales activities run efficiently for members and staff. The Universal Service Representative II procures business for the branch by maintaining member relationships and...


  • San Antonio, United States CHRISTUS Health Full time

    DescriptionSummary: The associate is responsible for the duties and services that are of a support nature to the Revenue Cycle division of CHRISTUS Health. The associate ensures that all processes are performed in a timely and efficient manner. The primary purpose of this position is to ensure account resolution and reconciliation of outstanding balances...


  • San Antonio, United States MGR Full time

    Job DescriptionJob DescriptionCollections & Billing Specialist- Contract to hire! The Collections & Billing Specialist is responsible for a high volume of Invoicing/Billing and collection efforts for company customers. This includes the following tasks:High Volume of Invoicing per contract termsContacting customers to resolve delinquent accountsNegotiating...