Patient Rep Biller Full Time Days

2 months ago


Los Angeles, California, United States Hollywood Presbyterian Full time
Job Summary

Hollywood Presbyterian is seeking a highly skilled Medical Claims Specialist to join our team. As a Medical Claims Specialist, you will be responsible for reviewing claims for accuracy, expediting billings to payers and patients, and ensuring that all necessary documentation is submitted with claims.

Key Responsibilities
  • Review claims for accuracy and completeness, and ensure that all necessary documentation is submitted with claims.
  • Expedite billings to payers and patients, and follow up on any issues or discrepancies.
  • Determine payer documentation requirements for payment, and ensure that all necessary information is available to be submitted with claims.
  • Transmit and submit clean claims to payers, and update the computer system to reflect submission and transmission of claims.
  • Review correspondence from payers, and provide corrections and/or documentation as needed.
  • Review payment data for suspension, underpayment, and denials, and submit appropriate responses.
  • Review bi-monthly accounts receivable reports to identify claims that have been submitted but not resolved or acknowledged, and take appropriate action to ensure resolution.
  • Prepare adjustments to ensure that balances reflect payable amounts, and forward to management for review and authorization.
Requirements
  • High school diploma or equivalent.
  • Three years of billing experience in a hospital setting, or five years of relevant hospital experience.
  • Knowledge of payer requirements and medical terminology.
  • 30 wpm typing and the ability to operate all department equipment and software programs.
Preferred Qualifications
  • N/A
Work Environment

This is a full-time position, working 40 hours per week, with a shift of 8:00am - 4:30pm, Monday through Friday.



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