Manages outpatient and inpatient billing work queues daily to ensure charges are reviewed, processed, and submitted accurately and within established timelines. Creates and maintains guarantor accounts and applies the appropriate carve-out insurance coverage based on the location and type of services rendered. Utilizes comprehensive knowledge of ICD-10 diagnosis codes, CPT procedure codes, and payer-specific billing requirements to ensure accurate charge capture and claim submission. Demonstrates a strong understanding of modifiers and billing regulations for Medicare, Medi-Cal, and commercial insurance payers. Communicate effectively with providers, clinical staff, patients, insurance representatives, and other stakeholders via telephone and email to resolve billing issues and support timely reimbursement. Maintains compliance with organizational policies and regulatory requirements. Performs other duties as assigned.
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Job Type
Full-time
Career Level
Mid Level