Senior Insurance Billing Clerk - Patient Accounting-Billing

County of Riverside•Riverside, CA

21h•Onsite

About The Position

The County of Riverside - Riverside University Health System (RUHS) - Medical Center is seeking a Senior Insurance Billing Clerk to join their Patient Accounting-Billing team in Riverside. Under general supervision, the incumbent will be responsible for reviewing and making follow-up determinations on denied claims while performing complex account resolution, leading and training staff, serving as a trusted resource in navigating challenging problems related to procedures, regulations, and complex accounts, drafting original correspondence, dispute letters, and appeals to payors—specifically for facility (hospital) billing and special programs—and providing exceptional customer service support to both internal and external clients, interpreting and explaining regulations, contractual language, and legal obligations, monitoring accounts for payment, and recommending solutions for delinquent accounts, reviewing patient insurance forms for accuracy, contacting patients and insurance companies to obtain treatment authorizations and verify eligibility, responding to requests for account information, and initiating calls to patients, insurers, and internal or external departments regarding billing and follow-up matters; leading and performing specialized and more difficult fiscal clerical work in connection with processing and billing fiscal intermediaries for medical services rendered to patients; and to do other work as required.

Requirements

Two years experience performing fiscal, statistical and fiscal record keeping functions with at least one year involving third party intermediary medical billing.
Knowledge of methods and terminology of financial and statistical clerical work including knowledge of general clerical auditing and verification techniques; General billing, medical terminology, and billing forms with knowledge of the application of computerized accounting systems.
Ability to lead staff; Understand and apply rules and regulations pertaining to medical billing policies and procedures while identifying routine billing errors and differentiate between appropriate applications of various billing methods; Perform basic mathematical computations rapidly and accurately; Organize work to meet prescribed deadlines.

Nice To Haves

Possess a medical billing certificate
At least 3 years of medical billing and/or collections, specifically in a hospital setting
Epic
Ability to review and interpret payor contracts
Knowledge of diverse payor mix - Medi-Cal, Medicare, Managed Care, Commercial and other Government payors
Bilingual
Detail and goal oriented
Good verbal and written communication skills

Responsibilities

Leads and trains staff; Serves as a resource for staff in the solution of difficult problems relating to procedures and regulations; Assists staff in resolving a variety of difficult problems.
Checks and corrects bills and accounts for numerical accuracy, proper coding and prepares ATP's for data entry.
Reviews patient accounts to determine the accuracy of account information and makes any required adjustments for proper billing purposes.
Registers patients for medical services such as emergency treatment care and non-emergency walk-in treatment.
Verifies billing account or insurance forms for completeness and accuracy against a variety of automated and manual records.