Billing Rep

CommonSpirit Health•Santa Maria, CA

About The Position

Where You’ll Work Dignity Health’s Pacific Central Coast Health Centers (PHC) is a non-profit Community clinic organization comprised of more than 40 health centers located primarily from Ventura to Templeton, spanning the coast. Our experienced physicians and advanced practice providers offer a wide range of primary and specialty care services. PHC is a part of Dignity Health Central Coast’s award-winning network of outstanding hospitals, imaging centers, laboratories, and post-acute services. One Community. One Mission. One California Job Summary and Responsibilities As our Billing Rep, you will help our patients and providers streamline the billing and insurance process so they can focus on patient care and financial well-being. Every day you will review and process patient accounts, insurance claims, and payment postings. You will be expected to ensure accurate and timely billing, follow up on denied claims, and maintain patient confidentiality. To be successful in this role, you must have strong attention to detail, knowledge of medical billing and coding, and experience with healthcare insurance. Quantity of billing. Following prescribed procedures, accurately prepares and submits electronic and hard-copy claims with required attachments measured by: Inpatient Claims: 8 per hour electronic; 3 per hour hardcopy. Outpatient Claims: 25 per hour electronic; 5 per hour hardcopy. Assessed by productivity reports. Quality of billing. Follows up on rejected, returned claims measured by Observation of claim rejection volume. Shows understanding and ability to produce and send clean claims. Understands and incorporates new regulations and procedures. Takes corrective action and communicates errors to the source as needed. Skill-Set-Demonstrates basic computer skills and data entry proficiency. Demonstrates basic knowledge of rules/regulations for billing different insurance types and payers. Documentation-Clearly documents comments on all patient accounts within Meditech. Teamwork-Achieves cooperation and teamwork with co-workers and hospital staff. Consistently demonstrates good communication and problem-solving skills. Compliance-Demonstrates understanding and adheres to HIPAA and compliance guidelines pertaining to handling of Private Health Information (PHI). Demonstrates the ability to complete assignments according to functional expectations with minimal supervision.

Requirements

Minimum one year prior healthcare billing experience required
Computer or keyboarding experience
High School Diploma or GED
strong attention to detail
knowledge of medical billing and coding
experience with healthcare insurance
Demonstrates basic computer skills and data entry proficiency
Demonstrates basic knowledge of rules/regulations for billing different insurance types and payers
Consistently demonstrates good communication and problem-solving skills

Responsibilities

review and process patient accounts, insurance claims, and payment postings
ensure accurate and timely billing
follow up on denied claims
maintain patient confidentiality
accurately prepares and submits electronic and hard-copy claims with required attachments
follows up on rejected, returned claims
produce and send clean claims
incorporates new regulations and procedures
Takes corrective action and communicates errors to the source as needed
Clearly documents comments on all patient accounts within Meditech
Achieves cooperation and teamwork with co-workers and hospital staff
Demonstrates understanding and adheres to HIPAA and compliance guidelines pertaining to handling of Private Health Information (PHI)
Demonstrates the ability to complete assignments according to functional expectations with minimal supervision