Job Detail

Applicant should have a minimum of one year experience. Pay rate based on experience and knowledge. Job is located on site in Laguna Hills, CA.

This is for a high volume surgical practice doing both general and vascular surgery. Must be able to multi-task, answer phones, register patients, code operative reports, do patient collections, write insurance appeals and prepare surgical estimates. Candidate should be highly familiar with insurance plans and their structure (i.e. Medicare, Medicare Advantage plans, Medi-cal for California, HMOs in CA, PPOs and workers comp). Self starter and self motivated only need apply. Experience with Athenahealth EMR/EPM a plus. Billing team has daily individual goals.

Requirements:

• Experience working in Medical Billing & Collections
• Knowledge of ICD-10, CPT & HCPCS coding
• Excellent customer service skills and professionalism
• Dependability
• Strong organization skills and detail oriented

Responsibilities:

• Advises office staff of need for updated demographics and acquires same from outside sources.
• Captures, reconciles, posts, and submits charges by creating, reviewing, and sending billing form.
• Communicates with providers regarding need for charge information.
• Communicates with clinical office staff and accesses hospital information to get records when needed to support claims.
• Transmits electronic claims, retrieves reports, and verifies transmission and receipt by clearing house and payer.
• Runs reports of pending claims and reviews according to schedule and performs follow-up. Releases pending claims to patient responsibility per EOB’s and payment advisories.
• Responds to written, phone, and electronic inquiries from patients and payers regarding claims and files secondary claims.
• Prints and mails statements, performs collection calls, manages financial need determinations, and sets up payment plans where indicated.
• Prepares letters of appeal on payment denials or insufficient payments.
• Maintains a working knowledge of payer systems and requirements.
• Notifies appropriate supervisor(s) of issues with provider’s participation with payers and / or credentialing status.

Job Type: Full-time

Pay: $16.00 - $25.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

COVID-19 considerations:
Following all CDC guidelines

Education:

• High school or equivalent (Preferred)

Work Location: One location