Job Description
Description
A Remote Insurance Follow-Up Representative (MediCal) will be responsible for all collection functions for hospital and physician services. This primary responsibility of this position is account resolution which includes the following duties: reviewing accounts, following up with Medi-Cal and various insurance companies on claim status, gathering and submitting any missing... information, rebilling, appeals, and billing out secondary electronic or paper claims to all payers as needed.
Duties/Responsibilities
Β Provide customer service to various healthcare contract customers
Β Prepare, research and collect from Medi-Cal and various contracted health insurance payers
Β Research remits and Explanation of Benefits (EOBs) for complete accurate payments or denials
Β Provide or arrange for additional information when needed
Β Submit corrected claims or appeals
Β Request appropriate adjustments, when required
Β Identify items that require client assistance
Β Gather payor trends and provide feedback
Β Other duties as assigned
Required Skills/Knowledge
Β Medi-Cal experience required
Β EPIC experience preferred
Β Microsoft Office
Β Knowledge in government and non-government billing guidelines for facility/physician
Β Knowledge in account/claim status, resolution, and appeals process
Β Knowledge of the UB04 and HCFA forms
Β Excellent customer service and time management skills
Β High attention to detail required
Β Excellent verbal, written, and electronic communication skills required
Education/Experience
Β High school diploma or General Education Development (GED) certificate required
Β One to Two years of college preferred
Β Minimum of three years of experience preferred
Β Prior medical billing and insurance collections or healthcare revenue cycle experience preferred
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