Job description

Summary

Reviews and responds to insurance requests regarding claims. Follows up on claims and resolves all issues regarding Private Payers (HMO-PPO), Hospitals, Assisted Living, other Institutions, and accounts in patient responsibility.

Primary Duties & Responsibilities include the following. Other duties may be assigned.

• Maintain monthly A/R reports: make claim status calls and/or use on-line portals for open claims, prioritize with oldest first and highest billed amount
• Processes and posts payments
• Remits statements
• Handle account follow-up and collections for all locations.
• Timely and complete response to all payer requests for additional information or documentation; obtain physician documentation as required.
• Generation of professional and clearly written appeal letters providing all requested information, addressing each reason for denial with clearly stated justifications for service, and providing support documentation.
• Review insurance bulletins and remain current on updates and changes.
• Assist with claims submission

Requirements:

• Medical Billing certification, 2 years’ experience in AR work in lieu of certification.
• Two years related experience in insurance claims follow up and management of medical collection accounts or equivalent combination of medical billing-claims follow-up training and work experience.
• Familiarity with public and private insurance plans and requirements.
• Familiarity with insurance and institutional billing procedures.
• Knowledge on use of basic office equipment (computer, telephone, photocopier, scanner, fax, etc.)
• Technical Skills - 40 wpm minimum typing speed.
• Ability to perform basic mathematical computations.
• Intermediate skills with MS Word, Outlook, and internet usage.
• Highly fluent in English language. Bilingual Spanish desired.
• Ability to work independently, manage time efficiently, and to effectively prioritize tasks.

Competencies:

To perform the job successfully, an individual should demonstrate the following competencies:

• Customer Service- Manages difficult or emotional customer situations; Responds promptly to customer needs; Meets commitments.
• Interpersonal Skills- Maintains confidentiality.
• Oral Communication- Speaks clearly and persuasively in positive or negative situations. Communication with patients, payers, and coworkers is non-emotional and professional.
• Written Communication- Writes clearly and informatively. Ability to compose business correspondence with proper use of English language.
• Professionalism- Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
• Quality- Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
• Quantity- Meets productivity standards; Completes work in timely manner.
• Safety and Security- Observes safety and security procedures; Reports potentially unsafe conditions; Uses equipment and material properly.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to stand, walk, and/or sit at computer station for several hours at a time. Ability to get up and down frequently throughout the day.
• The employee must occasionally lift and/or move up to 15 pounds.

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Signature Date

_______________________________________________________

Employee Name

Job Type: Full-time

Pay: $16.00 - $20.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Health insurance
• Life insurance
• Paid sick time
• Paid time off
• Vision insurance

Physical setting:

• Office

Schedule:

• 8 hour shift
• Monday to Friday

Ability to commute/relocate:

• Bakersfield, CA 93301: Reliably commute or planning to relocate before starting work (Preferred)

Experience:

• Accounting: 2 years (Required)
• Medical Billing: 2 years (Required)

Work Location: In person

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