Billing & Collections Representative Ii - Pfs
1 month ago
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
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