Job Description

BILLING ACCOUNT REPRESENTATIVE - HEALTHCARE

HYBRID OPPORTUNITY! (1-2 in the office - Laguna Hills, California, 3 days remote)

 

**Candidates should live within 30 minutes from Laguna Hills, California**

 

Qualified candidate should possess:

  • Billing re: Claims accuracy with minimum collection
  • Billing Insurance companies for Medical Claims
  • Managing and monitoring information from guarantors and/or delinquent accounts to solicit payments
  • Responsible for record of collections and status of accounts, taking in/outbound calls to assist with patient account balances
  • Knowledge of billing/collection policies and procedures
  • HMO, PPO, POS, Medicaid experience required
  • 1+ year of Billing/Customer Service in a Healthcare setting

 

Here we Grow! Because the need to care for children in this age is growing and changing, we are looking for an intelligent, caring Billing Account Representative who will join a mission-driven group that is focused on the health of children and the well-being of the family from an operational perspective. Our healthcare practice has grown from its South Florida roots since 1955 across Texas, California, Arizona, New York and there is more to come. At Pediatric Associates, our employees receive competitive salary, a generous PTO program, competitive benefits including a 401K with a Company match of up to 3.5%. With over 65 years of providing LOVING CARE to our patients, we offer the stability and security of an established practice with the excitement of a growing healthcare organization.

Apply on line, email or call us directly, and learn why this is a rewarding career move for you! This is a wonderful time to join our Big Orange PA Family!

Benefits at a glance:

  • 3 Comprehensive Medical Plans
  • Part Time Medical Plan
  • Dental
  • Vision
  • Basic Life and Accidental Death and Dismemberment (AD&D) Company Paid
  • Long Term Disability (LTD) Company Paid
  • Short Term Disability (STD)
  • Voluntary Term Life Insurance (Employee/Spouse/Child)
  • 401K Retirement Plan
  • Voluntary Benefit Plans
  • Life Assistance Plan (EAP)
  • Tuition Reimbursement
  • Paid Time Off
  • Paid Holidays
PRIMARY FUNCTION:  Patient Account Representative is responsible for managing and monitoring all tasks and communication related to the intake of information from guarantors and/or delinquent accounts to solicit payment. Other duties include: keeping records of collections and status of accounts, and taking incoming and make outbound calls to assist with patient account balances. 
 
ESSENTIAL FUNCTIONS OF THE JOB: (This list may not include all of the duties that may be assigned.) 
 
1.    Monitor queue to ensure calls are being handled professionally and appropriately. 
 
2.    Perform analysis, research, and making decisions to appropriately handle phone inquiries. 
 
3.    Review accounts and responsible for completing adjustments to ensure correct reimbursement as instructed by Manager. 
 
4.    Identify delinquent accounts, aging period, payment sources, and correct any claim processing (data entry, verification, coding and/or posting) errors identified. 
 
5.    Manage requests for medical records, correspondence, and/or Explanation of Benefits (EOB). Research proper processing and/or payment of accounts from patients with or without insurance. 
 
6.    Responsible for collection efforts and for taking the appropriate steps to have claims processed for payment (i.e. re-submitting claims or filing claims appeal for payment or additional payment). 
 
7.    Keeps Manager abreast of any changes, and documents any problems related to work methodology procedural and recommends actions. 
 
8.    Identify and resolve patient billing disputes by evaluating patients’ financial status, establishing budget payment plans, collecting payments, and refunding patient credits.  
 
9.    Demonstrate good judgement and reads and abides by the company’s code of conduct, ethics, employee handbook, policies and procedures and other corporate mandates. 
 
10.     Accountable for limiting the use and disclosure of Protected Health  
 Information (PHI) for patients and employees information to the Minimum   
 Necessary in order to perform job. 
 
11.    Other various duties as assigned, including cross training in other functional areas. 
*Non patient-facing 
 
PERFORMANCE REQUIREMENTS
 
Adhere to all organizational information security policies and protect all sensitive information including but not limited to ePHI and PHI in accordance with organizational policy, Federal, State, and local regulations. 
 
TYPICAL WORKING CONDITIONS:  
Indoor Work 
Operating Computer 
Reach Outward 
Manual Dexterity 
Lift/Carry 10 lbs. or less 
Sitting 
 
Other Physical Requirements: 
Vision 
Sense of Sound 
Sense of Touch 
 
EDUCATION: High School Diploma or equivalent required. 
 
LICENSURE/CERTIFICATION: None 
 
EXPERIENCE: Minimum 1 year of customer service experience in a healthcare setting required. 
 
KNOWLEDGE, SKILLS & ABILITIES:  
*     Knowledge of billing and collection policies and procedures, all types of insurance (HMO, PPO, POS, Medicaid etc.) Skill in defining problems, interpreting billing information.  
*     Ability to multi-task in a face paced environment while meeting established production and quality goals/metrics.  
*     Strong organizational skills, with ability to effectively prioritize work and daily basis and follow up on open items in a timely manner.  
*     Must have strong verbal, written, and interpersonal communication skills  
*     Demonstrates ability to work well in a team environment.  
*     General PC knowledge including Microsoft Office, Internet and Email. 

 

Application Instructions

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