Billing Representative

Job Title
Billing Representative
Job ID
27699239
Location
Fountain Valley,  CA 92708
Other Location
Description

POSITION SUMMARY: Responsible for all billing collections verifications for COA and Thrive Therapy patients to obtain eligibility and benefits with various types of payers; inputting, updating and correcting patient information and benefits in the computer system as required.

Coastline Orthopaedic Associates is looking for a qualified medical biller. Apply today! 1+ year(s) medical billing experience preferred.

A Medical Biller, or Insurance Billing Specialist, is responsible for organizing patient medical costs and sending invoices to collect payment from patients and their insurers. Their duties include calling patients to discuss payment and develop reasonable payment plans, entering patient data into administrative systems and recording information about outstanding claims.



MAJOR RESPONSIBILITIES (ESSENTIAL JOB FUNCTIONS):
  • Duties include:

  • Perform posting charges
  • Perform completion of claims to payers
  • Conduct duties in a professional and timely fashion
  • Submit billing data to the appropriate insurance providers
  • Process claims
  • Resolve denial instances
  • Achieve maximum reimbursement for services provided
  • Deploy, maintain and report on various programs
  • Do Medicare reviews
  • Do Medi-Cal reviews
  • Conduct audits
  • Obtain eligibility and benefits via source of computer website to print out a copy of the verification, by telephone and complete the yellow verification sheet with all pertinent information filled out, or request a fax back copy.
  • Review verification information and note the necessary copay or deductible amount to front office staff to collect from the patient at the time of service.
  • File verification paperwork in chart on the appointment date
  • Notify front office staff to cancel and/or reschedule any appointments with eligibility/benefits problems.
  •  Notify appropriate billing representative to pre-notify patient of any high or unsatisfied deductible amounts to be collected at the time of service.
  • Document in patient's account ledger eligibility and benefits information obtained as well as all pertinent information.
  • Input patient's demographic, insurance company and/or medical group in computer system.
  • Assign financial classifications to patients account as required.
  • Re-verify any new insurance changes and update patient's file in computer system as needed and notify appropriate parties involved addressing the changes.
  • Inform appropriate office staff with changes and updates with various insurance payers, medical groups and IPA as arise upon verification.
  • Document in all patient's account ledgers of actions taken on account upon completion.
  • Assist with other duties as assigned by manager.
POSITION REQUIREMENTS: Education, experience, and skills
MINIMUM
• High School diploma or equivalent.
• Knowledge of CPT and ICD-9 codes
• Must be well organized and detail oriented
• Working knowledge of HMO/IPA, PPO , Work Comp guidelines
• Computer literate
• Good verbal and written communication skills
• Must be able to work well under time deadlines

PREFERRED
• Diploma or equivalent
• At least 1 year medical insurance verification experience
• 1 years related job experience
_________________________________________________________________
PHYSICAL REQUIREMENTS IN ACCORDANCE WITH ADA:
Carrying/Lifting: Lifting and carrying charts and supplies.
Standing: Assisting patients and performing Billing Manager duties on floor.
Sitting: Floor procedures, computer work, paperwork, and phones.
Walking: Assisting patients, transporting supplies, performing Billing Manager duties.
Repetitive Motion: Reaching and grasping, keyboard activities.
Visual Acuity: Ability to view computer monitor and read.
Environmental Exposure: Patient contact.
Speaking and Hearing: Communicating with patients and coworkers.
 
Pay Range
$17.00   Hourly to $21.00   Hourly

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