Talent.com
Medical Billing Representative - CPC Preferred

Medical Billing Representative - CPC Preferred

San Diego Cardiac Center Medical Group IncSan Diego, CA, US
job_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

Job Description

Job Description

Summary of Position : The Accounts Receivable / Follow-up Specialist is an integral member of the reimbursement team and has primary responsibility to oversee follow-up activities for all third-party payers and assigned accounts. This includes collecting payments for outstanding insurance claims, researching denials, submitting appeals, claim resubmissions and ensuring payments received are reconciled correctly. Performs a variety of complex clerical and accounting functions for patient billing, including verification of encounter information, maintenance of insurance plan files, resolution of claims errors, rejections, and payer denials. Recreates and re-bills claims to insurance companies and other entities, prepares refunds, adjustments and write-offs, identifies accounts for appeals and coordinates cash posting activities with collection and cash posting staff. Additionally, as a Medical Biller and Coder, this role accurately converts patient diagnoses and procedures into alphanumeric codes (like ICD-10, CPT, and HCPCS) to submit and manage claims, ensuring accurate reimbursement from insurance companies and patients.

Primary Duties and Responsibilities :

A / R Follow Up & Appeals :

  • Perform account follow-up on outstanding and denied insurance balances and take the necessary action for account full resolution. This includes making outbound calls to payers and / or accessing payer websites / portals.
  • Collaborate with insurance payers to determine why claims have been denied and obtain the information required to expedite full reimbursement.
  • Research CPT and ICD-10 coding correlation, CCI edits, contractual agreements, and Medicare billing guideline for each specific claim / case to ensure highest reimbursement.
  • Prepare and submit reconsiderations forms and appeals processes in accordance to the payer requirements to substantiate claim reimbursement.
  • Working from the accounts aging reports to meet or exceed daily claim follow-up productivity standards. Includes generating and analysis of aging summary report to determine the scope of the problem or denial trends requiring follow-up.
  • Document all follow-up activity taken on an account in the account notes to ensure an audit trail.
  • Review professional billing (1500) components for accuracy. Make necessary changes as required in accordance with billing laws.
  • Works independently to analysis problem claims and process appropriate to resolve the account to full reimbursement.
  • Ensures strict compliance to HIPPA requirements and Medicare compliance.
  • Familiar with terms such as HMO, PPO, IPA and Capitation
  • Understanding / ability to read an EOB

Medical Coder :

  • Ensuring that codes are assigned correctly and sequenced appropriately as per government and insurance regulations
  • Complying with medical coding guidelines and policies
  • Receiving and reviewing patients' charts and documents for verification and accuracy
  • Following up and clarifying any information that is not clear to other staff members
  • Collecting information made by the Physician from different sources to prepare monthly reports
  • Implementing strategic procedures and choosing strategies and evaluation methods that provide correct results
  • A strong understanding of physiology, medical terms and anatomy
  • General :

  • Ensures strict confidentiality of financial and medical records
  • Participate in development of organization procedures and update of forms and manuals.
  • Performs a variety of general clerical duties, including telephone reception, mail distribution, and other routine / miscellaneous functions as assigned.
  • Proficiency in computer skills including typing speed and accuracy
  • Mathematics skills
  • Excellent written and verbal communication skills
  • Organizational skills
  • Ability to maintain a high level of integrity and confidentiality of medical information
  • Strict attention to details
  • Knowledge of data entry
  • Assist other Billing Representatives and Management with a variety of other daily tasks
  • Respond to email, EHR messages / tasks throughout the day
  • Be a team player : Identify how you might assist fellow team members
  • Always represent SDCC and its staff and Providers in a professional, courteous, and respectful manner on or off the property
  • Position Requirements :

  • Certified Professional Coder (CPC) required
  • Minimum 1 years' experience that is directly related to the duties and responsibilities specified.
  • Understanding of HCFA-1500 & UB claims form and re-billing process.
  • Experience with medical coding guidelines and procedures such as ICD-9, CPT, ARG and ASA, among several others.
  • Knowledge of surgery, CPT and ICD-10 coding and billing.
  • Assertive and goal oriented.
  • Ability to communicate effectively both orally and in writing, often in stressful situations.
  • Superior customer service skills.
  • Ability to handle multiple tasks simultaneously under strict deadlines.
  • Proficiency in MS Windows and Office Suite
  • Cariology experience preferred
  • Position Specifics :
  • Full time
  • Monday-Friday
  • 7 : 30 am to 4 : 30 pm (hours are flexible)
  • In-office; not a remote position
  • serp_jobs.job_alerts.create_a_job

    Billing Representative • San Diego, CA, US

    Job_description.internal_linking.related_jobs
    • serp_jobs.job_card.promoted
    Billing Supervisor

    Billing Supervisor

    TradeJobsWorkForce92191 San Diego, CA, US
    serp_jobs.job_card.full_time
    Billing Supervisor Job Duties : Accomplishes billing human resource objectives by selecting, ori...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Biller

    Biller

    Health Advocates NetworkSan Diego, CA, US
    serp_jobs.job_card.full_time
    Comprehensive health, prescription, dental, vision, life, and disability plans.Referral opportunities? Refer a friend & Cash in!. Travel reimbursement and per diem allowances.Health Advocates Networ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Medical Billing Eligibility and Authorization Coordinator

    Medical Billing Eligibility and Authorization Coordinator

    San Diego Cardiac Center Medical Group IncSan Diego, CA, US
    serp_jobs.job_card.full_time
    As an internal and external client-facing professional, the Medical Billing and Eligibility and Authorization Coordinator is a key position in the Revenue Cycle, manages the claims process, includi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Epic Resolute Professional Billing Analyst (100% REMOTE)

    Epic Resolute Professional Billing Analyst (100% REMOTE)

    Amerit ConsultingChula Vista, CA, United States
    serp_jobs.filters.remote
    serp_jobs.job_card.permanent
    Our client, a Medical Center facility under the aegis of a California Public Ivy university and one of largest health delivery systems in California, seeks an accomplished.Resolute Professional Bil...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Billing Project Specialist (Medical Billing)

    Billing Project Specialist (Medical Billing)

    ExagenCarlsbad, CA, US
    serp_jobs.job_card.full_time
    Exagen is a patient-focused and discovery-driven life sciences company dedicated to transforming the care continuum for patients suffering from debilitating and chronic autoimmune diseases.Our goal...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Medical Billing

    Medical Billing

    TradeJobsWorkforce92159 San Diego, CA, US
    serp_jobs.job_card.full_time
    REQUIRED SKILLS • Type minimum of 50 words per minute • • Excellent letter writing skills • Proficiency in MS Excel • Detail-oriented, good follow-through • Proficiency in MS Word • Windows environmen...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Medical Biller - Healthcare Claims

    Medical Biller - Healthcare Claims

    GuidehouseSan Marcos, CA, US
    serp_jobs.job_card.full_time
    The Medical Biller is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to fac...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Medical Billing - Earn Up to $37 / hr

    Medical Billing - Earn Up to $37 / hr

    TradeJobsWorkforce92119 San Diego, CA, US
    serp_jobs.job_card.full_time
    REQUIRED SKILLS • Type minimum of 50 words per minute • • Excellent letter writing skills • Proficiency in MS Excel • Detail-oriented, good follow-through • Proficiency in MS Word • Windows environmen...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Part-time Insurance Biller

    Part-time Insurance Biller

    Roya Niakiani, DMDSan Diego, CA, US
    serp_jobs.job_card.full_time
    A Part-time Insurance Biller and play a vital role in ensuring our patients receive the coverage they deserve.With a focus on patient care and community service, you'll be part of a dynamic tea...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Epic Resolute Professional Billing Analyst (100% REMOTE) (San Diego)

    Epic Resolute Professional Billing Analyst (100% REMOTE) (San Diego)

    Amerit ConsultingSan Diego, CA, US
    serp_jobs.filters.remote
    serp_jobs.job_card.part_time +1
    Our client, a Medical Center facility under the aegis of a California Public Ivy university and one of largest health delivery systems in California, seeks an accomplished.Resolute Professional Bil...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Billing Specialist

    Billing Specialist

    Remax Express TjTijuana, Baja California, México
    This position ensures proper documentation, compliance with internal controls, and effective communication with both internal departments and external customers. The ideal candidate is detail-orient...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Insurance Biller I (Temporary)

    Insurance Biller I (Temporary)

    Neighborhood HealthcareEscondido, CA, US
    serp_jobs.job_card.full_time
    Community health is about more than just vaccines and checkups.It’s about giving people the resources they need to live their best lives. At Neighborhood, this is our vision.A community where ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Medical Billing Representative

    Medical Billing Representative

    San Diego Cardiac Center Medical Group IncSan Diego, CA, US
    serp_jobs.job_card.full_time
    The Medical Billing Representative will be responsible for miscellaneous daily functions in the medical billing office.Reliability with high attention to detail and organizational skills is needed ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Medical Biller Dermatology Group Practice

    Medical Biller Dermatology Group Practice

    Bernardo Dermatology Medical GroupPoway, CA, US
    serp_jobs.job_card.full_time
    We are seeking a an experienced Medical Biller to join our team! This position is involved in all elements of revenue cycle management. We utilize an EHR / Practice Management system called EZDerm and...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Billing Specialist

    Billing Specialist

    REMAX Express TJTijuana, Baja California, Mexico
    This position ensures proper documentation, compliance with internal controls, and effective communication with both internal departments and external customers. The ideal candidate is detail-orient...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Medical Billing Clerk

    Medical Billing Clerk

    TradeJobsWorkforce92193 San Diego, CA, US
    serp_jobs.job_card.full_time
    REQUIRED SKILLS • Type minimum of 50 words per minute • • Excellent letter writing skills • Proficiency in MS Excel • Detail-oriented, good follow-through • Proficiency in MS Word • Windows environmen...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Billing Analyst

    Billing Analyst

    LHHSan Diego, CA, US
    serp_jobs.job_card.full_time
    Live in San Diego and interested in a hybrid position with an industry leading and thriving San Diego based company? In this role you will have great exposure company wide and will be able to serio...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Insurance Biller II

    Insurance Biller II

    Neighborhood HealthcareEscondido, CA, US
    serp_jobs.job_card.full_time
    Community health is about more than just vaccines and checkups.It’s about giving people the resources they need to live their best lives. At Neighborhood, this is our vision.A community where ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30