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 company is seeking a Patient Account Representative specializing in Hospital Billing (HB). The primary goal of this role is to diligently follow up on unpaid hospital claims from commercial and government payers, ensuring timely reimbursement. You will be instrumental in contacting insurance companies to ascertain claim status, resolve payment discrepancies, and maintain accurate account documentation within billing systems.
Key Responsibilities
- Research and resolve denial codes.
- Review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs).
- Correct claim errors and billing edits.
- Submit corrected claims and appeals.
- Resolve missing documentation or medical record requests.
- Investigate authorization and referral issues.
- Resolve coordination of benefits (COB) issues.
- Research and resolve credit balances and overpayments.
- Follow up on partial payments and underpayments.
- Document account activity in Epic HB or other billing systems.
- Work a minimum of 50 accounts per day while consistently meeting productivity and quality standards.
Qualifications
- Demonstrated capability to meet a productivity quota of 50 accounts per day.
- Proven track record meeting high quality and productivity metrics in previous roles.
- Ability to reach full performance standards within an 8-week (60-day) ramp-up period.
- High-level expertise dealing directly with Anthem rules, denials, and claim resolution processes; UHG experience is a plus.
- Experience navigating organizational change and software migrations is critical due to ongoing system updates and upcoming IT initiatives.
Experience
- Minimum of 2 years of A/R or Patient Account experience.
- Minimum of 2 years of Epic System experience.
Skills
- Proficiency and expertise with the Epic System.
- Strong payer follow-up experience, specifically with Dean Health.
Work Schedule
Monday - Friday, 8:00 AM - 5:00 PM (with a 30-minute lunch break).
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.
*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.
Any required state or Joint Commission training is compensated at the state or local minimum wage rate.
*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.
