Patient Account Rep Commercial Ins Biller

Job Description

Job Description

There are two (2) positions available for this opportunity.

Under the supervision of the Insurance Billing Manager, this position is responsible for the timely and accurate billing of Commercial, Senior Managed Care and Group insurance inpatient and outpatient accounts and secondary insurance. This includes the pre-billing, billing and electronic submission of hospital claims; identification and processing of appropriate write-offs, accurate use of HMO matrix to identify responsible payer, identification of stop loss claims and “carve out” items that are reimbursed at different rates. Ensures compliance to the payer’s contracted billing requirements. Coordinates with the Medicare and Medi-Cal team for any MSP issues, HMO acknowledgements or Medicare/Medi-Cal as secondary billing. Meet and exceed the minimum productivity volume, and standards of work as defined within the departmental policies and procedures.

• Demonstrated ability to use a 10key adding machine, calculator, fax machine, photocopy machine keyboard for data entry and personal computer (PC)
• Ability to perform multiple tasks, good mathematical skills, sound decisionmaking abilities and good verbal and written communication skills
• Ability to learn new systems, become proficient in development of reports via hospital systems and tools provided, proficient in excel and word document for appeal submission to payers
EDUCATION/EXPERIENCE/TRAINING Required:
• High School Graduate
• 2 years hospital billing and follow up experience
Preferred:
• 2 years college
• Knowledge of hospital billing requirements and regulations
• Knowledge of Commercial, Senior Managed Care or group insurance billing requirements and regulations.
• Evidence of continuing education
• Understanding of CMS rules and regulations concerning of accurate claims submission