Description

Billing and AR Specialists Lead is responsible for:

• Managing charge entry, EDI rejections and AR Collections workflow
• Load balance EHR billing queues to ensure turnaround time goals are met
• Managing follow up on all payers to achieve full payment of claims processed
• Coordinating and supervising work performed by outside billing staff
• Coordinating and overseeing work performed by internal billing staff
• Coordinating access to payer portals (Availity, Optum, Etc.)
• Coordinating and adding payers in ECW
• Professionally managing escalated patient complaints via email, letter correspondence, phone or in person
• Good decision making to help create a profitable but patient centric environment
• Effectively communicating with management, staff and patients

OTHERS

• Respects patients by recognizing their rights; maintaining confidentiality.
• Attend all meetings and trainings as required
• Extensive technical and functional California payer claims process knowledge
• Strong action and results focus, self-management and the ability to prioritize and track multiple time sensitive activities and projects simultaneously
• Excellent problem-solving skills and strong communication skills, both written and verbal
• Perform other duties as assigned

The pay range for this position is between $25.00 - $35.00 hourly, and depends on several factors such as experience, education, skillset, and abilities. This position will work a hybrid schedule, which includes a combination of working both onsite at Corporate (UTC- La Jolla) and remote.

Qualifications

QUALIFICATIONS

• Education: Associate’s Degree in healthcare, CPC Certification highly preferred but not required
• Experience: 2 years of experience managing healthcare billing department workflows

KNOWLEDGE, SKILLS, AND ABILITIES:

• Outgoing personality
• Compassionate nature
• Strong communication skills Above average critical thinking skills
• Customer service experience to exceed expectations
• Experience with basic computer programs including e Clinicalworks software, Daisy bill, Office365, and third-party eligibility and authorization portals
• Strong knowledge and understanding of all insurance types such as PPO, HMO, EPO, Government, Managed Care and Workers Comp plans
• Knowledge and experience of pertinent and current California Labor code provisions pertaining to workers’ compensation rules and regulations of the California Division of Industrial Accidents and Workers’ Compensation Appeals Board