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Medical Biller/Claims Specialist

Sacramento, CA

Posted: 09/06/2019 Employment Type: Temp-to-Hire Position Industry: Healthcare/Medical Job Number: 41674.1
A not for profit is seeking Medical Billers/Claims Specialists to support their busy revenue cycle department. The Medical Billers/Claims Specialist will be responsible for intake of new claims, ensuring all CPT/ICD-10 codes are correct and sending it out the door for processing and payment. Ideal candidates will have experience with both Medicare, Medi-Cal insurances, UB and CMS claims. This is an exciting opportunity to work for an organization that provides services to the Medi-Cal and Medicare populations and works hard to provide both high quality and affordable health care to the underserved.

Responsibilities: Performs all claims and billing functions, pulling information off patient record, coding the claim and sending out for payment. Coding for both UB-04 and CMS-1500 Claims. Researches claim rejections, making corrections, taking corrective actions and/or referring claims for timely resolution. Conducts account follow up including the investigation of payment delays resulting from pending claims. Evaluates accounts, resubmits claims, and performs refunds, adjustments, write-offs and/or balance reversals, if charges were improperly billed or if payments were incorrect. Responds to customer service inquiries, complaints or issues regarding patient billing and collections (telephone, fax, mail and web-based patient portal).

Requirements: 1-2 years' medical billing/claims experience. Certified Billing & Coding highly desirable. Demonstrated experience working with Medicare, MediCal, Medicaid, HMO, and PPO Claims standards, processes, policies, procedures and service level agreements. Familiarity with medical terminology and the medical record coding process. In-depth knowledge of Revenue Cycle applications, including Hospital Patient Accounting. Type 50 wpm. High attention to detail and accuracy. Excellent communication skills (verbal and written). Strong ability to identify, prioritize, resolve and / or escalate complex problems promptly.Ability to use good judgement and clear a criminal background check.

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