Job Summary :

Communicates with patients, government agencies and third party payers to gather, process and record information to receive appropriate reimbursement.

Communicates with departments for charge information, coding updates, and other information for claim appeals. Completes billing and collection processes and prepares for distribution to appropriate sources.

Reviews unpaid claims and obtain necessary information to resolve reimbursements. Works on routine assignments within defined parameters, established guidelines and precedents.

Follows established procedures and receives daily instructions on work.

Job Requirements :

Education and Work Experience :

• High School Education / GED or equivalent : Preferred
• Associate’s / Technical Degree or equivalent combination of education / related experience : Preferred

Essential Functions :

• Reviews, corrects and submits claims to payers. Applies developing / basic working knowledge and experience to the job.
• Reviews unpaid accounts, initiates correct actions to collect the accounts, and follows up on action to assure expected results is achieved.
• Meets or exceeds productivity and quality performance expectations.
• Reviews unpaid accounts and initiate collection action for past due and denied claims. Calculates write-offs and debit / credit adjustments.
• Provides general office support as needed.
• Performs other job-related duties as assigned.

Organizational Requirements :

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc.

as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.

Last updated : 2024-07-29