Account Representative - Secondary Insurance Billing - Marinhealth, Northern Ca Job In Piedmont, Uni

Published 2022-08-08
Expires 2022-09-08
ID #1119376383
Account Representative - Secondary Insurance Billing - Marinhealth, Northern Ca Job In Piedmont, Uni
United States, California, Piedmont,
Published August 8, 2022

Job details:

Job type: Full time
Contract type: Permanent
Occupation: Account representative - secondary insurance billing - marinhealth, northern ca

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Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life’s best work.SM

Under the general guidance of the Supervisor, the Account Representative, Commercial will be responsible for, but not limited to, the following duties: initial and follow up billing; account follow up; correction of errors; appealing claims; working with outside vendors and overall resolution of accounts.

Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 05:30am - 02:00pm PST. Our office is located at 3950 Civic Center Drive San Rafael, CA 94903.

Primary Responsibilities:

Responsible for timely and correct initial billing of accounts to the correct payers utilizing hospital information and EDI vendor

Correction of claims, based on personal knowledge and system identified errors to assure claims are submitted accurately

Performs timely follow up with the payer to determine status of claim and processing of the payment

Utilizing personal skills developed, performs timely follow up through phone calls, investigative work, re-bills and on-line applications to assure accounts are resolved in a timely and efficient manner

Responsible for maintaining current and ongoing knowledge of State and Federal guidelines as they pertain to the accurate resolution of accounts

Responsible for reviewing the Expected Payment variance reports for incorrect payments on accounts

Responsible for all accounts assigned to assure the hospital receives accurate and timely payment

Ability to manage work flows to assure accounts are not lost due to timely billing and other preventable errors

Identified underpayments are reviewed to determine the reasons and appropriate actions taken to correct the discrepancies.  These actions may include, but not be limited to phone calls, appeal letters, working with the attending MD and HIM

Identifies specific problems or trends, develops appropriate tracking tools, and keeps Manager and Director informed

Responsible for handling all levels of questions and issues from insurance companies, appropriate governmental agencies, patients, and doctor’s offices

Responsible for maintaining productivity within overall established Business Office guidelines.  All variances in overall productivity will be evaluated and corrective action developed with Management

Researches and completes credit/charge corrections and write-offs

Handles all written correspondence addressed to their area

Utilizes the Hospital Information system to research accounts in a timely and effective manner

Maintains copies of appeals and correspondence either at workstation, cash folders or personal filing systems.  Copies must be maintained in alphabetic order by year of service

Correspondence could include: arbitration appeals for Managed Care, 1st report of injuries, follow up letters specific to claims and carriers, ABN’s, and TAR’s

Prepares financial agreements, creditors’ claims, probate forms, bankruptcy claims and Worker’s Compensation liens

Participates actively in the achievement of organizational and departmental goals

Attends and participates in in-services and staff meetings.  Maintains standards of the organization and department

Abides by hospital policies on attire, work habits and relationships.  Observes confidentiality and decorum in conversation and behavior

Assists in the orientation of new employees

Other duties as assigned
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

High school diploma / GED (or higher)

1+ years of progressive experience working in a small to medium size acute care hospital business office

Experience should be specific to account handling from billing to account resolution

Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.
Preferred Qualifications:

Strong working knowledge of all areas related to the resolution of non-Government accounts and the regulatory requirements for each payer

Overall skills would be specific to the type of accounts handled, whether it is HMO, PPO, Work Comp, County, Champus etc.,
Soft Skills:

Ability to work tactfully and professionally with patients, family members, hospital staff, medical staff, outside payers

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    Unitedhealth Group
    Registered on October 7, 2017


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