Government Biller-Collector Per Diem Days

Pipeline Health•Cerritos, CA

1d•Onsite

About The Position

Responsible for timely billing and follow-up for all acute care Medicare claims according to State and Federal regulations. Reviews and resolves credit balances. Works all denials and or rejections from the billing work ques timely. Submits accurate contractual adjustments and proper documents for each account. Responsible for inputting accurate data into excel spreadsheets. Pull data for audits and assist with special projects and or backlogs within the office. Actively and consistently contributes to department operations and communications, behaves in a manner consistent with the mission, vision, and values of Pipeline Health, upholding standards of AIDET (Acknowledge, Introduce, Duration, Explanation, Thank you) patient communication.

Requirements

At least two (2) to three (3) years of current experience in an acute care hospital setting.

Nice To Haves

Computer skills preferred.

Responsibilities

Download claims in billing system daily or as needed.
Monitor & process credit balances for refunds and transfers in accordance with department procedures.
Process daily bills via OPTUM MDE system.
Process claims and bills to payors through bill editor in accordance with department procedures.
Print Remittance Advices.
Work on denial accounts daily or as needed.
Work on daily rejection daily or as needed.
Work on daily mail and correspondence.
Work off the work ques and clear ticklers efficiently.
Maintain quality control on all accounts for correct plan ID’s and financial class.
Update system with appropriate changes.
Send requests to ancillary departments for reports needed to bill claims in a timely manner.
Keep current with updates and changes within the Medicare m via CMS website.
Retrieve any patient information from the HBF system.
Process daily contractual adjustments.
Calculate payment and contractual adjustment according to expected reimbursement.
Work and resolve aged accounts.
Identify under and over payments.
Ensure each account has detailed documentation as required by the department procedures.
Meet productivity requirements daily.
Provide Medicare RA’s to cross over biller.
Prepare credit balance reporting every quarter to Medicare.
Demonstrate ability to reach decisions, take appropriate action and follow through within scope of responsibility, as defined by job description.
Process secondary billing and transfers in accordance with department procedures.
Perform all other duties and special projects as assigned.
Perform basic unit/department maintenance such as keeping files, drawers, cabinets free from unnecessary clutter.
Abide by HIPAA (Health Insurance Portability and Accountability Act) regulations.
Complete and attend monthly training assigned.
Wear nametag properly; follow dress code policy; answer phone correctly and promptly; be prepared for meetings; meet deadlines; do not participate in gossip; act ethically and treat others with respect; respect customer’s and co-worker’s time; establish and maintain effective relationships with customers and co-workers.
Provide accurate and timely written and verbal communication of information in a manner that is understood by all.
Listen, understand, problem-solve, and carry-out duties to ensure the optimal outcome.
Use IT systems in an accurate and proficient manner.
Contribute toward effective, positive working relationships with internal and external colleagues.
Demonstrate cooperation, flexibility, reliability, and dependability in all daily work activities and a willingness to collaborate with others for the good of the customer and the organization.