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Posted: May 17, 2024
Salary:US$18 - US$22 per hour
Location:Loma Linda
Job type: Permanent
Discipline:Revenue Cycle
Work Location:On-site

Job description

  1. Analyzes and audits accounts for correct balance, proper follow-up and complete reimbursement. Processes all payor rejections/denials and follows up to resolve accounts in accordance with department standards.
  2. Reviews and works with outside agency/department lists, EOBs, CSM requests, to verify patient services are coded correctly and payment has been applied properly.
  3. Identifies misapplied payments, requesting payment adjustments/transfers or refunds.
  4. Reviews/corrects registration/insurance data utilizing all available sources to obtain correct information. Requests Insurance authorizations, including Service Authorizations (SARs) for CCS and Treatment authorizations (TARs) for Medi-Cal when necessary for account resolution.
  5. Processes all approved charge corrections timely, verifying proper adjudication for payor eligibility, following all Medicare/Medi-Cal/CCS and other payor guidelines.
  6. Processes correspondence for accounts and takes appropriate billing action.
  7. Receives and resolves phone issues/questions. Pulls appropriate documentation; takes proper action and documents through computer.
  8. Completes correspondence/tickler logs weekly maintaining department standards for work in progress.