Demo

Medical Billing & Collections Representative

PrideStaff
Fresno, CA Full Time
POSTED ON 1/22/2025
AVAILABLE BEFORE 4/21/2025

Currently we have an open position for a full-time, temp-to-hire Medical Billing and Collections Representative. The hourly wage will be 22.00 - 28.00 per hour, depending upon experience and knowledge. Please see additional details below.

Medical Billing and Collections Representative

The primary duties include but are not limited to; Facilitate and use best strategies for the optimization of revenue, billing, and collections process. Utilization of claims worklist and HUB to maintain timely resubmission of held / denied claims and timely follow up. Research coding, billing, and charge compliance. Recommend corrective action, escalate problematic claims with payors as needed. Work a daily average of 24 claims per day. Provide support to the front office staff on billing issues, data entry and improvement opportunities. Abide by all applicable confidentiality laws and requirements, company policies and procedures, Federal and State regulations, and laws. Duties and assignments may vary as determined by the Practice Administrator and / or billing and / or patient care issues.

General qualifications

  • Medical Billing & Terminology Certification
  • Two-year college degree is preferred

Required Knowledge, Experience and Skills

  • Intermediate knowledge of ICD9 / 10 and CPT coding, insurance terminology and billing software
  • Basic mathematical calculations to balance and reconcile transactions
  • 4 plus recent years' experience in submitting corrected, additional information, disputed and appealed medical claims
  • Excellent English written and oral communication skills
  • Maintain confidentiality of patient care and business information
  • Working knowledge of computers, office equipment, MS 365, proficient use of Email systems
  • Payor portal navigation and utilization
  • COB resolution
  • Strong negotiation skills
  • Current NCCI edits knowledge
  • Experience with clearinghouse claims corrections and resubmissions
  • Familiar with Medicare, PPO, HMO, WC and TPA payer billing guidelines
  • Familiar with billing secondary and tertiary payors
  • Strong customer service role in medical administration or billing
  • Self-motivated and have the ability to prioritize work and meet deadlines
  • Compensation / Pay Rate (Up to) : $22.00 - $28.00

    Salary : $22 - $28

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