Job description

We are looking for an Insurance Follow Up Rep to join our client’s growing revenue cycle team! Please apply if interested and to be considered for other open roles at YOH!
Pay Rate: Up to $32/hourly
Location: San Francisco, CA

Day to day duties:

• Fully resolving denied claims for Medi-Cal, Managed Care (commercial) payors.
• Providing support for AR clean-up project.
• Manually appealing denied claims and resubmitting cleaned claims.

Requirements:

• Strong familiarity with commercial and government payers, including Medicare and Medicaid
• Experience with billing for specialties (such as neurology, gynecology, nephrology, dermatology, etc.)
• Working knowledge of ICD-10 and CPT codes
• Understanding of HIPAA guidelines/regulations

Responsibilities:

• Manage claims that are billed out for various specialty procedures
• Complete claim edits and resubmissions within timely filing guidelines
• Provide insight to clinical staff regarding why claims are denied and how denials can be avoided in the future to maximize collections
• Develop relationships with patients, clinical staff, insurance payers, and other revenue cycle specialists
• Collaborate with insurance payers to determine why claims have been denied and what information is needed to resubmit claims successfully

The Government, Commercial, Contract and Managed Care (CCMC) Units are responsible for the accounts receivable, billing, and follow-up of all government or commercial, contract and managed care payers. The units deal regularly with complex policy and procedural issues that involve contract compliance with regard to Medicare, Medi-Cal, CCS, HMO and PPO payers. It is the units’ responsibilities to communicate and to coordinate throughout various medical center departments, including the company billing agents to ensure the quality of the university’s billing process.

Within these units, the Follow-Up Representatives are responsible for billing and follow-up of government, commercial, contract and/or managed care accounts receivables for MGBS clients. The incumbent demonstrates the ability to perform all aspect of billing and follow-up with quality. The incumbent’s main task is to resolve all outstanding insurance accounts through constant communication with the payers (by phone or via web access), other MGBS units, medical center clinical departments and billing agents.

When resolving the accounts receivables; the Follow-Up Representative must adhere to the MGBS SRG (Situation Response Guide) to ensure consistency with the follow-up and documentation processes and to maintain good quality work. The Follow-up Representative must meet minimum productivity standards and quality expectations of their units. The Follow-up Representative must attend and be engaged in unit and team meetings aimed at increasing knowledge. The incumbent will utilize web based tools, including payor websites and the RMS website prior to calling payors. The incumbent will conform to all medical center, MGBS, government and HIPAA policies and procedures.

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Visit https://www.yoh.com/applicants-with-disabilities [1]to contact us if you are an individual with a disability and require accommodation in the application process.

Links:
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[1] https://www.yoh.com/applicants-with-disabilities
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