Insurance/Patient Billing Follow-Up

Sante Health•Fresno, CA

21h•$18 - $25

About The Position

Sante Health System is hiring a full-time Insurance/Patient Follow-Up position responsible for insurance and patient balance follow-up, aging reports, and customer service. The role reviews aged accounts receivable and determines and completes appropriate actions to help ensure payment is received. It also assists sites and patients with questions and concerns, establishes patient payment schedules, documents work performed, and maintains strict confidentiality. Sante Health System is a management services organization serving multiple clients and is one of the largest healthcare claims and billing management companies in Central California. It coordinates services among physicians, health plans, hospitals, and ancillary providers to benefit patients in a managed care environment. The company describes its culture as talented, driven, dedicated, innovative, and service-driven, and offers competitive pay, benefits, and advancement opportunities.

Requirements

High school diploma or GED certificate.
Knowledge of ICD-10, CPT, and HCPC coding.
Knowledge of billing regulations for PPO, HMO, Workers' Compensation, and government payers.
Knowledge of patient confidentiality regulations.
Professional telephone etiquette.
Professional customer service skills and the ability to multitask, prioritize, and manage time effectively.
Excellent communication skills.
Knowledge of Government, PPO, HMO, Workers' Compensation, Medicare, Medi-Cal, Non-Contracted Plans, and Private Pay billing and guidelines.

Nice To Haves

Two years of medical billing experience.

Responsibilities

Review aged accounts receivable and determine and complete the best course of action to ensure payment is received.
Review and respond to denials and correspondence.
Submit corrected claims or tracers.
Add or remove modifiers, diagnoses, and informational comments.
Contact patients when additional information is needed.
Update account information, including patient demographics and insurance information.
Contact payers to discuss claim status and request review.
Notify insurance companies to expedite claim payment through web portals or phone calls.
Attach additional claim documentation as needed, such as medical records, primary EOBs, or authorizations.
File check tracers.
File appeals, reconsiderations, and reopening requests.
Review, analyze, and maintain account aging according to approved management and client goals.
Assist sites and patients with questions and concerns.
Set up patient payment schedules.
Document all work performed as directed.
Notify management of concerns about unusual payments or insurance claim processing.
Attend required meetings and in-services.
Comply with work rules, including safety and health requirements.
Perform related work and other duties as assigned by the manager.
Maintain strict confidentiality and follow other job-related instructions and duties as requested.