Errors Processing Specialist - Yosemite Pathology Medical Group

The Errors Processing Specialist plays a critical role in integrating billing and revenue best practices in response to payor rejections for the contracted, non-contracted, government payor groups. This position focuses on updating patient demographics, obtaining valid insurance information, clearinghouse rejections, accounts receivable management, and other various tasks related to accounts receivables. The successful candidate will ensure accurate billing, timely reimbursement, and compliance with industry standards.

Essential Functions

• Answer and direct phone calls
• Respond to emails in a timely manner
• Keep desk current as timeframe deemed appropriate by manager; reach daily KPI
• Update patient demographics and insurance information as needed
• Review and resolve daily Error Processing worklists (bad addresses, no authorization, eligibility undetermined, etc.) in a timely manner
• Correspond with clients, patients, and insurance companies
• Forward qualifying accounts to third party collections agency as needed
• Always adhere to HIPAA compliance, including when accessing client portals
• Pro-actively identify clearinghouse rejection trends and communicate to manager
• All other duties as assigned

Job Requirements and Skills

• 3+ years of medical billing experience (Pathology billing experience is a plus)
• High school diploma
• Advance knowledge of PPO, HMO, IPA, CMS, Managed Medi-caid/Managed Medicare
• Working knowledge of CPT/ICD Codes
• Knowledge of eligibility and benefits
• Detail-oriented and ability to demonstrate a positive and proactive attitude
• Ability to work cooperatively with others in a team environment
• Self-starter with solid organizational skills and ability to effectively manage multiple priorities or reprioritization of projects
• Excellent written and verbal communication skills
• Documentation skills, ability to research and resolve issues
• Ability to multi-task with a results-oriented paradigm in a fast-pace, high volume environment
• Ability to read and interpret EOB's
• Proficient in Microsoft Office Suite - Strong Excel and Word skills are required