Responsible for submitting accurate claims, ensuring timely reimbursement from third-party payers and patients, and maintaining proper documentation in the facilities' billing system. Works closely with Revenue Cycle teams and payers to follow up on claims, resolve denials and payment variances, and support accounts receivable reduction efforts.
- Reviews denied and underpaid claims to identify discrepancies
- Communicates with payers by phone and web portals to resolve outstanding claims
- Documents account status, expected payments, and payer interactions
- Tracks denial trends and supports root-cause analysis and system improvements
- Maintains compliance with HIPAA, federal/state regulations, and payer requirements
- Updates payer contact and reference information
- Participates in quality improvement efforts and productivity goals
- Performs other duties as assigned
Requirements & Qualifications
Minimum Qualifications
- 2-3 years of relevant experience
- Minimum of 2 years of recent billing and follow-up experience in hospital and/or physician clinical areas
Preferred Experience
- Medicare or Medi-Cal (Medicaid) billing experience
- EPIC Hospital Billing and/or Physician Billing experience
- Knowledge of Critical Access and RHC billing
Other Requirements
- No educational requirement specified
- No license or certification required
Location
California, US
Employment Type
Not specified
Experience Level
Associate
Remote work allowed
No
Posted
4 weeks ago