Errors Processing Specialist

Yosemite Pathology Medical Group•Modesto, CA

13d

About The Position

Yosemite Pathology (YP) is a private independent pathologist owned and operated surgical pathology and cytology laboratory based in Modesto, CA. YP provides comprehensive state of the art, reliable, and accurate diagnostic services to its physicians and major area hospitals in the Alameda, Amador, Calaveras, Contra Costa, Kern, Mariposa, Merced, San Joaquin, Solano, Stanislaus and Tuolumne counties. YP offers a full spectrum of tissue pathology, cytology and histology services, including examination of gynecologic specimens, body fluids and fine needle aspiration specimens. We also offer an extensive array of special stains and immunohistochemistry to assist in the management of oncologic and non-oncologic diseases. The laboratory is supported by highly qualified Histotechnologist, Cytotechnologist, Technicians and office staff who offer excellent service. Summary/Objective The Error Processing Specialist is responsible for supporting the revenue cycle through accurate and timely billing operations, error resolution, and account follow-up. This role focuses on ensuring clean claim submission, maintaining data integrity, and resolving issues that may delay reimbursement. Key focus areas include eligibility and insurance verification, payor portal utilization, front-end billing processes, professional communication, and effectively managing high-volume workloads. The ideal candidate is detail-oriented, proactive, and capable of working efficiently in a fast-paced environment while maintaining compliance with all regulatory requirements.

Requirements

Minimum of 3 years of medical billing experience (pathology billing experience preferred)
High school diploma or equivalent required
Advanced knowledge of PPO, HMO, IPA, CMS, Managed Medicaid, and Managed Medicare plans
Working knowledge of CPT and ICD coding
Strong understanding of insurance eligibility and benefits verification
Proficiency in payor portal utilization and navigation
Knowledge of front-end billing processes and workflows
Demonstrated professional phone etiquette
Proven ability to manage high-volume workloads efficiently while maintaining accuracy
Detail-oriented with a proactive, positive approach to problem-solving
Ability to collaborate effectively in a team environment
Strong organizational skills with the ability to manage multiple priorities and adapt to changing demands
Excellent written and verbal communication skills
Strong documentation, research, and issue resolution capabilities
Ability to multitask in a fast-paced, high-volume, results-driven environment
Proficiency in reading and interpreting Explanation of Benefits (EOBs)
Proficient in Microsoft Office Suite, with advanced skills in Excel and Word

Nice To Haves

pathology billing experience preferred

Responsibilities

Answer and appropriately direct incoming phone calls
Respond to emails promptly and professionally
Maintain an organized and up-to-date work queue in alignment with manager-defined timeframes; consistently meet daily KPIs
Update patient demographics and insurance information as needed
Review and resolve daily Error Processing worklists (e.g., invalid addresses, missing authorizations, undetermined eligibility) in a timely manner
Perform eligibility and insurance verification to ensure accurate billing and reimbursement
Utilize payor portals to review claim status, verify benefits, and resolve issues
Execute front-end billing processes, ensuring clean and accurate claim submission
Communicate effectively with clients, patients, and insurance carriers
Demonstrate professional phone etiquette in all interactions
Refer qualifying accounts to third-party collection agencies as appropriate
Maintain strict adherence to HIPAA regulations, including when accessing client portals
Proactively identify clearinghouse rejection trends and escalate findings to management
Effectively manage a high-volume workload while maintaining accuracy and productivity standards
Perform additional duties as assigned