A Medical Biller handles payments and financial transactions between health care providers and patients. Manages systems for mailing bills and collecting and recording payments. Works in healthcare facilities and hospitals.
Laguna Hills, CA Job Details $28 - $30 an hour 6 hours ago Qualifications Appeals Customer communication Microsoft Excel Microsoft Outlook Accounts receivable management Customer service Account troubleshooting Health insurance policy knowledge Financial issue resolution Medical insurance appeals management Medical claims submission Billing issue inquiries Insurance claims appeal handling Collections account management Full Job Description Careers Great people form the core of any great organization. PreludeDx is always looking for highly qualified people with a passion for improving the lives of cancer patients. We will periodically post information about openings but are always interested in hearing from those who believe in our mission and values. For more information, contact:
Job Title:
Medical Biller/Collector Department:
Revenue Cycle Reports To:
Director, Revenue Cycle Management Location:
Laguna Hills, CA (onsite)
Compensation:
$28-30/hr
Hours:
8am-5pm M-F Description This position will perform collections and medical billing for various regional and national payers, including Federal, State, Third Party (HMO, PPO, IPA, TPA Indemnity) and Patient Billing. Qualified candidates must be able to (1) Review accounts for billing accuracy in order to maximize reimbursement. (2) Persuasive and tenacious follow-up on claims status (3) Appeal, and re-bill or forward claims for recalculation and / or adjudication as necessary. Must possess detailed knowledge of all medical benefit levels and have a thorough understanding of Federal, State, PPO, HMO, and Indemnity Plans structure. Must meet or exceed the standard level of performance on assigned accounts.
ESSENTIAL RESPONSIBILITIES
Data entry, correct insurance assignment to patient accounts, insurance eligibility verification. Review/update demographics and patient information for accuracy. Working knowledge of appropriate coding systems; CPT, ICD-9 and HCPCS, coverage; LCD/NCD and reimbursement associated with such codes. Processing, validation of payer requests and processed claims via correspondence, remittance advice and EOBs (i.e., identification of payment discrepancies, inappropriate requests) Investigate all denied services to determine the reason for the service denial, appeal, if appropriate. Identify, report root causes associated with denials Timely, effective processing of assigned appeals including development, submission, tracking, reporting and evaluation of appeal outcomes (i.e., next steps, improved outcomes) Maximize utilization of Billing system, tools, and resources to support cash collection activities. Review and work various reports including aging, adjustments and credit balances. Comply with Federal and State legislation pertaining to all billing related matters. Comply with all Safety, Emergency, Hazard, OSHA, HIPAA, Quality Assurance and Administrative Plans, Policies, Guidelines, Protocol, and Standards. Support and maintain department cash and DSO goals Other duties as assigned The above list represents the general duties considered essential functions of the job and is not to be considered an exhaustive description of all the work requirements that may be inherent in the position. Requirements High School Diploma and a minimum of four years related experience or a Bachelor's degree from a four-year college or university; or equivalent combination of education and experience Working knowledge and prior hands-on experience of medical billing and reimbursement. Proficient in Microsoft Outlook, Excel, Word, the Inter and Intranet and other programs/software as necessary. Problem solving skills, using good judgment, attention to detail and follow-through are a must. Excellent customer service skills; excellent verbal and written communication skills. Ability to prioritize work, multi-task and time management skills. Support cross-trained culture Excellent troubleshooting and time management skills, attention to detail, utilizes time in constructive manner Ability to easily adapt to increased business demands Ability to effectively work with and resolve complex accounts & billing issues Self-starter, ability to work independently Flexible and reliable Ability to effectively prioritize and multi-task Ability to work in fast paced environment, perform under pressure, meet tight timelines Establish and maintain cohesive and good working relationships. Excellent communication and customer service skills; cooperative, work collaboratively and treat others in respectful, professional and supportive manner.
ABOUT PRELUDEDX
PreludeDx is an Innovative Healthcare company and leading personalized breast cancer diagnostics company dedicated to serving breast cancer patients and physicians worldwide. Founded in 2009 with technology licensed from University of California San Francisco, PreludeDx has focused on developing precision breast cancer tools that will impact a patient's treatment decision. Our mission is to provide patients and physicians with innovative technologies that improve patient outcomes and reduce the overall cost burden to the healthcare system. Before making a treatment decision, Know Your Risk™. www.preludedx.com
