Looking to take your career to the next level? Have a passion for the medical field and a high level of care provided? We have the job for you!! Large Revenue Cycle Management Company is looking for a Patient Account Representative to join their team! Biller will be responsible for managing the billing for California and Arizona based accounts.

Company provides casual work environment, employee appreciation programs, excellent benefits and more!

What will I be doing?

The ideal candidate has past experience doing follow-ups on aged accounts that have been billed to health plans and have partial balances that need to be figured out as far as denials, non-covered charges that need to be adjusted, rebill with medical records, etc.

This involves logging into the web portals of these health plans to check the status of the previously-billed claims and then maybe calling the health plans directly to inquire about vague denial codes on the web portal or inquire further with an actual representative from the health plan.

Knowledge of CPT codes and modifiers is important because these health plan reps will try to give bogus explanations as to why certain procedures aren't covered, need to be bundled or whatever the case might be which may not always be true.

Especially when speaking to offshore call centers that represent the health plans.

Assertiveness, experience and knowledge are key attributes for this candidate as they'll be reviewing accounts and making judgments on resolving the unpaid charges.

Experience having submitted Appeal letters and other correspondences to the health plans, seeking reconsideration of denied services. B

• Experience primarily with 'hospital' accounts billed on UB-04 claims to 'Medi-Cal Managed Care' health plans. If the candidate's past experience is limited only to follow-up on Physician CMS-1500 claims, it is not sufficient for this position.
• Need to have experience having worked at a provider that billed their accounts on UB-04 claims, and to Medi-Cal HMO plans specifically.

We really need someone who can hit the ground running with minimal training needs.

Must haves :

• 4 years Medical Collections experience
• Acute Care Hospital Billing experience
• Strong knowledge of Medi-Cal Managed Care payers
• Medicaid experience is a plus!

Last updated : 2024-04-23