Billing Rep Lead

Where You’ll Work Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California, Arizona and Nevada. Today, Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers, we provide increasing support and investment in the latest technologies, finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled, qualities that are vital to maintaining excellence in care and service. Job Summary and Responsibilities As our Billing Rep, you will help our patients and providers streamline the billing and insurance process so they can focus on patient care and financial well-being. Every day you will review and process patient accounts, insurance claims, and payment postings. You will be expected to ensure accurate and timely billing, follow up on denied claims, and maintain patient confidentiality. To be successful in this role, you must have strong attention to detail, knowledge of medical billing and coding, and experience with healthcare insurance. Demonstrates a solid understanding of accounts receivable and your role as the A/R Billing Rep Lead to include: Payor Rules & Regulations; Understand Contract Language; CCI Coding Issues; Read and interpret DOFR; Comprehend how transaction affect account; Coordination of Benefits Rules; Offsets & Recoups; Ability to determine correct systems to locate pertinent info; IDX, Medical Records Systems, Insurance Payor Websites, Code Correct. Provide in-depth analysis of inventory to identify possible system issues, payer denial trends and areas for staff training development. Resolves claim edits Independently researches and analyzes complex issues/accounts with available resources and tools. This may include direct contact with payor to determine if staff actions(s) taken are in compliance with current workflows and policies. Maintains, tracks and compiles audit scores within the expected turn around time. Works directly with A/R Billing Supervisor to ensure compliance with billing regulations on all discrepancies identified in an audit. Job Requirements Required High School Diploma or GED Five (5) years experience working in healthcare Rev Cycle or a Professional Medical Office One (1) year experience with IDX Practice management system Knowledge of physician billing regulations Understanding of professional claims and billing procedures. Knowledge of Federal and State regulations applicable to Government and Insurance Collections Excellent written and verbal communication skills #J-18808-Ljbffr Dignity Health Medical Group