Billing & Collections Representative Ii - Pfs - San Diego, United States - Rady Children's Hospital-San Diego

Rady Children's Hospital-San Diego

Verified Company

San Diego, United States

2 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

JOB SUMMARY:

Under the direction of the Supervisor Professional Billing & Coding follows Federal State & local regulatory collection guidelines as well as payor specific billing/collection guidelines.

Responsible for the collection of outstanding balances from all Commercial HMO PPO Medi-Cal & Managed Care payors professional claims. Responsible for identifying issues checking status of unpaid claims by telephone websites and/or any means available. Responsible for providing information & documentation to ensure timely & accurate reimbursement. Manages & assembles all data & documents required for accurate follow-up of claims. Ability to perform complicated calculations to adjudicate accounts appropriately. Ability to analyze & adjudicate contractual arrangements as determined by agreements entered into by the Medical Practive Foundation. Reviews remittance codes from EOB-s & R/A-s to ensure payment or to identify denials or non-payment. Responsible for follow up with payor on the routing of claims. Refers all payor issues/problems to leadership in a timely manner with specific examples.

Responsible for accurate & timely documentation of all follow up pertaining to the resolution of the account within the IS system patient financial record.

Skills Required:

Strong verbal and written communicator
Problemsolver
Master negotiator
Emotional Intelligence
Attention to detail

MINIMUM QUALIFICATIONS:
High School Diploma, GED, or Equivalent

3 years of experience

Previous billing experience

**The expected hiring range for this position is $22.00 to $30.26