Insurance/Patient Billing Follow-Up

Job Description

Job Description

Sante Health System is looking to hire a full-time Insurance/Patient Follow-Up  position is responsible for insurance and patient balance follow-up, aging reports and customer service.

• High school diploma or GED certificate required.
• Two years of medical billing experience preferred.
• Knowledge of ICD-10, CPT, and HCPC coding.
• Demonstrates professional customer service with the ability to multi-task, prioritize and manage time effectively.
• Excellent communication skills required.
• Knowledge of Government, PPO, HMO, Workers' Compensation, Medicare, Medi-Cal, Non-Contracted Plans and Private Pay billing and guidelines.

PERFORMANCE REQUIREMENTS
Knowledge, Skills and Abilities

• Knowledge of ICD-10, CPT and HCPC coding.
• Working knowledge of billing regulations for PPO, HMO, Workers' Compensation and Government payers.
• Knowledge of patient confidentiality regulations.
• Professional telephone etiquette.

1. Review and analyzing aged account receivables, determining and completing the best course of action to ensure payment will be received, including:
   1. Reviewing and responding to denials and correspondence.
   2. Submitting corrected claims or tracers.
   3. Adding/removing modifiers, diagnosis and informational comments.
   4. Contacting the patient if additional information is needed.
   5. Updating account information as needed, including patient demographics and insurance information.
   6. Contacting the payer to discuss status and request review.
   7. Notify insurance companies to expedite payment of claims, via web portal or phone call.
   8. Attaching additional documentation to claims as needed such as medical records, primary eob's or authorization.
   9. Filing check tracers.
   10. Filing appeals, reconsiderations and re-opening requests.
2. Review, analyze and maintain account aging per approved management and client goals.
3. Assist sites and patients with questions and concerns.
4. Set up patient payment schedules.
5. Notate and document all work performed, as directed.
6. Notify management of any concerns on unusual payments or claim processing from insurance companies.
7. Attend required meetings and in-services.
8. Comply with all work rules including those pertaining to safety and health.
9. Perform related work as required; perform other job duties as assigned by manager.
10. Maintains strictest confidentiality.
11. In the spirit of teamwork, employees are expected to follow any other job-related instructions and to perform any other job-related duties as requested.

Sante Health System is a Management Services Organization that serves multiple clients. "Sante" is the French word for health. Our name symbolizes our commitment to good health, progressive care, and leadership in our community.

Sante is one of the largest healthcare claims and billing management companies in Central California. The strength of Sante is the extraordinary network of physicians, health plans, and other health service providers it offers the people of our valley. Sante coordinates with physicians, health plans, hospitals, and ancillary providers to ultimately benefit the patient in a managed care environment. Sante Health System provides numerous client services such as billing, claims processing, contracting, credentialing, finance, human resources, information services, marketing/communications, physician services, practice management, provider relations, quality improvement, and utilization management.

Sante is celebrating over 30 years of service to the community. We deeply understand that we would not be successful in enhancing the quality of life of our patients without our incredible team. Therefore, we have created a work culture that is comprised of talented, driven, dedicated, innovative, and service-driven professionals. We provide competitive pay, excellent benefits including medical, dental, vision, and life insurance, 401k retirement plan, paid time off, and opportunities for advancement. Being part of our team is like being part of a big family. Join our team and make Sante Health System your home away from home.

If you feel you are the right fit for our position, we want to meet you! Apply now with our initial 3-minute, mobile-friendly application! We look forward to meeting you!