Medical Billing Specialist
1 week ago
We are seeking a detail-oriented and experienced Medical Collections Representative to join our team. This position will focus on insurance claims follow-up, denial management, and medical billing processes, with a particular emphasis on Epic Resolute Professional Billing and Professional Fee (ProFee) billing.
Key Responsibilities:
- Follow up on insurance claims to resolve outstanding issues, ensuring timely and accurate payment.
- Manage denial resolution and escalation, applying knowledge of medical billing and payer requirements.
- Work within Epic Resolute Professional Billing to process claims and ensure compliance with payer guidelines.
- Communicate with insurance companies and providers to address billing inquiries, verify information, and resolve discrepancies.
- Navigate payer websites and provider services to research claim statuses, manage denials, and correct errors.
- Maintain accurate records of claim follow-up actions and outcomes to ensure transparency and compliance.
- Assist with medical billing inquiries, specifically in Professional Fee (ProFee) billing and Government Professional Fee billing.
- Stay current on industry best practices and payer guidelines, including Medi-Cal managed care processes.
Required Skills and Qualifications:
- Epic Resolute Professional Billing experience.
- Experience in medical billing, with a preference for Professional Fee (ProFee) billing.
- Familiarity with payer websites and payer provider services.
About the Job
This is a hybrid position requiring onsite training and monthly in-person meetings thereafter. The role requires familiarity with payer websites, insurance provider services, and government billing processes, specifically Medi-Cal managed care.
BenefitsThe company offers various benefits, including medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits, and a 401K plan. Associates may be eligible for paid leave, including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
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