What are the responsibilities and job description for the Medical Biller position at eTeam?
Job Title Collector I - Medical Biller
Facility
Hoag Memorial Hospital Presbyterian
Duration
9 months
Location
2995 Red Hill Ave, Suite 200 Costa Mesa, CA 92626
Schedule Notes
8-430 pm
25 - $32 / Hour W2
Duties : Position Summary :
- The Collector serves as the account representati ve for Hoag in working with insurance companies,government payors, and / or patients for resolution of payments and accounts resolution.
- Completes assigned accounts within assigned work queues.
- Obtains the maximum amount of reimbursement by evaluating claims at the contract rate with the use of the contract management tool for proper pricing (Examples : APC, DRG, APRDRG).
- Reviews and initiates the initial appeal for underpayments observing all timely requirements to secure reimbursement due to Hoag.
- Reviews and completes payor and / or patient correspondence in a timely manner.
- Escalates to the payor and / or patient accounts that need to be appealed due to improper billing, coding and / or underpayments.
- Reports new / unknown billing edits to direct supervisor for review and resolution.
- Has a strong understanding of the Revenue Cycle processes, from Patient Access (authorizations admissions) through Patient Financial Services (billing & collections), including procedures and policies.
- Has thorough knowledge of managed care contracts, current payor rates, understanding of terms and conditions, as well as Federal and State requirements.
- Interprets Explanation of Benefits (EOBs) and Electronic Admitt ance Advices (ERAs) to ensure proper payment as well asassist and educate patients and colleagues with understanding of benefit plans.
- Understanding of hospital billing form requirements (UB04) and familiar with the HCFA 1500 forms.
- Knowledge ofHMO, POS, PPO, EPO, IPA, Medicare Advantage, Covered California (Exchange), capitation,commercial and government payors (i.e. Medicare, Medi-Cal, TriCare, etc) and how these payors process claims.
- Demonstrates knowledge of and effectively uses patient accounting systems.
- Documents all calls and actions taken in the appropriate systems.
- Accurately codes insurance plan codes.
- Establishes a payment arrangement when patients are unable to pay in full at the time payment is due.
- May review for applicable cash rates, special rates, applicable professional and employee discounts.
- May process bankruptcy and deceased patient accounts.
- Performs other duties as assigned.
Skills :
Required Skills & Experience :
Preferred Skills & Experience :
Education : Required Education :
Preferred Education :
Required Certifications & Licensure :
Preferred Certifications & Licensure :
Salary : $25 - $32
