Medical Billing Support Services Associate

Medical Billing Support Services Associate I

The Medical Billing Support Services Associate I coordinate and performs all aspects of the processing of cash receipts from automated and manual payers in accordance with training materials, scripts, and standard operating procedures. Position also performs a variety of duties which may include reviewing overpayments, credits and recoupments. Making phone calls and/or using payers web portals to check patient eligibility or confirming status of pending recoupments. This role is a Hybrid Remote role. Candidate must live within Los Angeles County.

Essential Duties:

• Understand the practice billing and collection system and process requirements for the automated and manual cash posting, batch balancing and reconciliation of cash receipts in the insurance billing process.
• Researches and analyzes un-posted cash on hand and unapplied cash to ensure timely posting and resolution.
• Investigate unapplied cash receipts and resolve or escalate in a timely manner to lead or supervisor.
• Reverses balance to credit or debit if charges were improperly billed.
• Contacts insurance carriers as necessary to determine correct payment application.
• Reviews correspondences related to refunds and or recoupments. Takes the necessary actions such as issuing a refund request or sending a dispute/appeal to the payer.
• Responsible for evaluating credit balances and ensuring that refunds are issued to the appropriate payer in a timely and accurate manner.
• Work with Finance and other Revenue Cycle Departments to optimize the cash posting, balancing and reconciliation process.
• Communicates issues related to payment posting and refunds from payers to management.
• Updates correct payer and resubmits claims to the payers.
• Consistently meets/exceeds productivity and quality standards.
• Cross trained and performs billing processes such as charge entry, insurance verification of eligibility and ensuring correct payer is billed, reviewing, and resolving billing edits from worklists.
• Cross trained and performs customer service duties as such as answering patient phone calls, patient email inquiries or division email inquiries related to patient balances.
• Contacting insurance payers on behalf of the patient and or with the patient on the call to resolve patient responsibility concerns. Review and resolve self-pay credit balances.
• Special projects assigned by leadership for example annual audits, escheatment reviews, payer projects, compliance monthly audits.
• Special billing and collections for LOAs.
• Special billing and collections for Case Rates.
• Special billing and collections for Embassy Services.
• Performs other related duties as assigned by management team.

Requirements:

Medical Billing, Medical Collections, Medical Claims, HMO PPO, Medi-Cal, EMR - Electronic Medical Records, Medical Appeals, Medical Denials