Patient Services Representative

Medi-Cal Billing - 8538


LOCALS ONLY
300 S Park Ave - 6th Floor, Pomona CA 91767

Start times varies from 7am to 830 am and end times depend on start time 330 pm to 500 pm


Education: High school diploma or GED required.


Experience: 1-3 years in hospital accounts receivable, medical billing, or healthcare collections.


Knowledge of hospital billing processes, CPT/ICD codes, and DRG reimbursement.
Familiarity with payer guidelines such as Medicare, Medi-call and commercial payers
Strong communication skills for payer interactions.
Proficiency in hospital billing systems and Microsoft Office.
Attention to detail and ability to analyze claim denials and payment variances.


Summary of Role:


Review hospital accounts receivable aging reports and prioritize collection efforts.
Contact insurance carriers to collect outstanding balances and resolve issues.
Knowledge in follow up for institutional claims ( UB04)
Investigate and appeal denied or underpaid claims to maximize reimbursement.
Coordinate with other departments such as billing team to resolve discrepancies.
Document all collection activities in the hospital's system
Ensure compliance with HIPAA, hospital policies, and state/federal regulations.
Obtaining Eligibility via website/insurance portals, insurance customer service