Patient Account Rep HB - Billing and Collection - FT - Days - Billing and Collection @ MV

El Camino Health•Mountain View, CA

3d•$34 - $51

About The Position

El Camino Health is committed to hiring, retaining and growing the best and brightest professionals who will carry our mission and vision forward. We are proud of our reputation in the community: One built on compassion, innovation, collaboration and delivering high-quality care. Come join the team that makes this happen. Applicants MUST apply for position(s) by submitting a separate application for each individual job posting number they are interested in being considered for. FTE 1 Scheduled Bi-Weekly Hours 80 Work Shift Day: 8 hours Job Description Unit Specific Duties: Billing Ensures claims are billed timely and accurately using the Hospital Claims Scrubber Tool and billing system. Resolves claim edits. Collaborates with departments to resolve applicable claim errors. Reports all unbilled claim information and issues that may delay billing to Management to ensure there is no adverse effect on Hospital Cash Collections or Accounts Receivable. Customer Service Receives and processes correspondence and phone or online inquiries from patients, payers or any other third party in a timely and professional manner. Resolves patient billing inquiries and processes patient payments over the phone or in person. Follow Up Follows up on unpaid and denied claims for account resolution. Resolves accounts by contacting managed care entities, other third party payer organizations or patients to facilitate timely payments. Performs research and makes determination of appropriate actions for payment resolution. Writes and submits appeals for denied claims. Keeps informed of managed care and contractual arrangements to resolve accounts by managed care payers. Assigns root causes to denials based on research. Payment Posting Posts daily cash and adjustments for Hospital and Professional billing. Resolves undistributed payments and performs cash reconciliation. Reports all payment issues to Management to ensure there is no adverse effect on Hospital Cash Collections or Accounts Receivable. Self Pay Credit Balances Resolves credit balances that are due to patients. Audits and reconciles accounts to confirm credit balance and submits refunds in a timely manner.

Requirements

High School Diploma or equivalent.
Two (2) years related work experience in a Hospital, Physician, or other healthcare setting.
Strong verbal and written communication skills.
Works in a collaborative and team manner.
Efficient organizational skills and effective reasoning, problem solving and critical thinking skills.
Excellent typing skills.
Ability to multi-task and demonstrate effective time management.
Strong attention to detail.
Ability to process a high volume of work.
Knowledge of medical terminology and billing.
Prior experience with facility billing or a similar role.
Understands Medicare, Medi-Cal, HMO, PPO and 3rd party rules and regulations.
Prior experience in a customer service setting.
Experience with claim processing and denial follow up and resolution.
Knowledge of insurance appeal writing.
Basic knowledge of contracting.
Understands Medicare, Medi-Cal, HMO, PPO and 3rd party rules and regulations.
Preferred cash and adjustment posting background with regards to quality control of payments and transactions to financial system.
10-key preferred.
10-key preferred.
Knowledge of basic accounting practices and procedures.

Nice To Haves

Preferred knowledge and use of Microsoft Products: Outlook, Word & Excel.

Responsibilities

Ensures claims are billed timely and accurately using the Hospital Claims Scrubber Tool and billing system.
Resolves claim edits.
Collaborates with departments to resolve applicable claim errors.
Reports all unbilled claim information and issues that may delay billing to Management to ensure there is no adverse effect on Hospital Cash Collections or Accounts Receivable.
Receives and processes correspondence and phone or online inquiries from patients, payers or any other third party in a timely and professional manner.
Resolves patient billing inquiries and processes patient payments over the phone or in person.
Follows up on unpaid and denied claims for account resolution.
Resolves accounts by contacting managed care entities, other third party payer organizations or patients to facilitate timely payments.
Performs research and makes determination of appropriate actions for payment resolution.
Writes and submits appeals for denied claims.
Keeps informed of managed care and contractual arrangements to resolve accounts by managed care payers.
Assigns root causes to denials based on research.
Posts daily cash and adjustments for Hospital and Professional billing.
Resolves undistributed payments and performs cash reconciliation.
Reports all payment issues to Management to ensure there is no adverse effect on Hospital Cash Collections or Accounts Receivable.
Resolves credit balances that are due to patients.
Audits and reconciles accounts to confirm credit balance and submits refunds in a timely manner.