Overview:
Qualifications:
This position is responsible for generating and submitting timely health insurance billing claims and/or patient statements. Includes follow up on unpaid claims and resubmission of unpaid claim documents. Resolve disputes in contested billing and initiate collection of patient copayments, deductibles and open balance amounts through telephone contact, letters, etc.
Responsibilities:- Responsible for generating and submitting timely health insurance billing claims and/or patient statements for multiple AltaMed locations.
- For outstanding claims identified through Aging Reports, research and re-submit overdue claims/statements within established timeframes.
- Identify credits, adjustments and write-offs, providing required documentation for approval by management.
- Verification of insurance eligibility and benefits as needed.
- Respond to customer inquiries regarding account status and resolve discrepancies, set-up payment schedules, and prepare adjustments and refunds when necessary.
- File, update and maintain all billing documentation.
- Review and resolve payment denials and claim rejections for specific payer groups; research explanation of benefits and re-submit within 48 hours of receipt.
- Review, analyze, audit individual accounts and conduct research.
- Perform other related duties as assigned.
- High school graduate or equivalent required; Trade or Technical School certification preferred.
- A minimum of three years billing and collection experience required; healthcare and/or business background strongly preferred.
- Bilingual: English/Spanish preferred.
