Job Detail

This position is a full-time, goal-oriented, revenue-driven, highly accurate and motivated individual. In collaboration with the billing department, the Accounts Receivable Specialist is responsible for daily and continuous monitoring of all payments to ensure all claims are paid correctly from the registration process through payment to ensure overall compliance for timely and accurate payment by all sources. Ongoing monitoring and follow up for payment requirements in accordance with AB1455. Adopt the Zymeda Provider Solutions, Inc. Team Culture as the back-bone of your work ethic and customer service. Uses a high-degree of personal and professional accountability to service the client billing needs.

Essential Duties and Responsibilities include the following:

• Periodic auditing and validation of clearinghouse batches being processed from EMR
• Coding and documentation support level of care, proper modifiers are used, etc.
• Performs various collection actions including denial management, contacting patients and insurance companies by phone, correcting and resubmitting claims to third party payers.
• Claims are submitted based on payer guidelines, e.g., Medicare vs. MediCal, LCD (neurosurgery) documentation for Medicare, etc.
• Working knowledge of medical terminology
• Ability to understand insurance contracts for billing and collection purposes
• Ability to prioritize and handle multiple tasks and projects concurrently
• Demonstrated knowledge and proficiency in the principles, procedures and best practices related to this position
• Thorough understanding of payers and payer contracts
• Ability to identify trends, issues, problems
• Respond to correspondence, phone calls, patients and third party requests.
• Maintain productivity standards and collection goals.
• Analyze patient accounts for balances owed.
• Establishes payment plans to help patients manage payment of bills.
• Rebills insurance companies or other third parties to secure payment for patients.
• Coordinate collection of outstanding monies not received during patient visits.
• Generate collection phone calls and correspondence for billing.
• Coordinate referral of bad debt accounts to collection agencies.
• Communicate regularly regarding the status of receivables, authorizations, and encounter issue trends.
• Prepare, review and send patient statements per client guidelines.
• Updates job knowledge by participating in educational opportunities; reading professional publications and providing staff with ongoing updates and training inclusive of, knowledge of CPT and ICD-10 coding
• Knowledge of client payer contracts
• Understands steps to escalation.
• Gathers, compiles, and analyzes billing and statistical analysis.
• Attend Training and/or seminars.
• Perform other duties as required.

About Zymeda:

We are a revenue cycle management company focused on providing physician practices with the consulting services, process improvement, operational benefits and revenue cycle capabilities enjoyed by large medical groups. As a growing company based in Southern California, our company offers clients a unique level of service complimented by access to our leadership team and industry experts.

The People:

Our team of Billing & AR specialists comprise of various backgrounds and experiences. We work together to make sure everyone has the training, resources, and knowledge to enjoy the tasks that make them and Zymeda successful. Many team members take advantage of opportunities to grow professionally because we also like to promote from within.

Team Culture:

We are committed to fostering a positive work atmosphere where hard work is mixed with fun so that our teams look forward to coming to work. We reward innovation, problem solving, and process improvements.

Check us out at www.zymeda.com