Responsible for accurately processing inpatient and outpatient claims to third-party payers and private payers in accordance with billing guidelines.
Processes tracers, denials, and related correspondence, initiates appeals, and prepares appeal letters for challengeable denial issues. Supports billing operations by reviewing credit balances, processing adjustments, transfers, and refunds, and researching misapplied payments.
Works as part of the billing team to maintain smooth operations, ensure timely filing, resolve claim edits, follow up on outstanding accounts, and maintain productivity and quality standards.
Requirements & Qualifications
- High school diploma or equivalent
- Experience with medical services collections across payers such as Medicare, Medi-Cal/Caid, HMO, PPO, commercial, and private pay
- Excellent written and verbal communication skills
- Strong knowledge of collection laws, policies, and procedures
- Knowledge of insurance, medical terminology, and reimbursement procedures
- Expert skill level in the specialty area
- Experience working in computing environments
- User support experience with servers, operating systems, workstations, networks, LANs, and network software
- Preferred: 2 years of medical services collections and computerized billing systems such as IDX
- Fire Life Safety Training (LA City) required within 30 days of hire if no card is held upon hire
Location
California, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
3 weeks ago