You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client seeks a Patient Financial Services Representative responsible for reviewing denied or underpaid claims, analyzing EOBs, medical records, account notes, and supporting documentation. You will identify denial reasons, prepare appeal packages, ensure timely submission, and track appeal progress. Collaboration with billing, clinical, and operational teams to reduce denials is crucial in this role.

Key Responsibilities

• Review denied or underpaid claims by analyzing EOBs, medical records, account notes, and supporting documentation.
• Identify denial reasons including authorization, documentation, coding, and payer-related issues.
• Forward denied encounters to the appropriate department/vendor for appeal preparation.
• Prepare, organize, and send appeal packages with all required documentation and signatures.
• Verify payer-specific appeal requirements and ensure timely submission.
• Print and organize medical records and charts for appeals processing.
• Follow up with insurance companies regarding appeal receipt, status, and determinations.
• Conduct frequent outbound payer follow-up calls and provide additional information as needed.
• Track appeal progress, reimbursement activity, and denial outcomes.
• Document all appeal activity, payer communication, write-offs, and overturned appeals within EPIC.
• Identify denial trends and recurring issues and escalate findings to leadership.
• Collaborate with billing, clinical, and operational teams to improve processes and reduce denials.
• Maintain accurate records and strong attention to detail while managing multiple accounts and deadlines.

Skills

• Epic experience
• Understanding of invoicing process for denials
• Planning and organizational skills
• Ability to multi-task
• Analytical skills: Ability to analyze complex data, identify trends, and make informed decisions.
• Problem-solving: Critical thinking and problem-solving skills to navigate complex denial reasons.
• Healthcare knowledge: Familiarity with payer guidelines, payer portals, and the claims process.
• Organizational skills: Ability to manage a large caseload, prioritize tasks, and meet deadlines.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

Medix is committed to a policy of Equal Employment Opportunity. Medix recruits, hires, trains, and promotes without regard to race, color, religion, sex, age, disability, veteran status, or other protected classes as specified by applicable state or local law.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.