Medical Collections- Authorizations hospice claims 24-00568 - Alura Workforce Solutions
Laguna Hills, CA 92653
About the Job
Title
Patient Account Representative
Position Type: Full time- On-site
Schedule: M-F, 8:00 am - 4:30 pm
Pay: $26- $31 an hour based off experience related to the position
DESCRIPTION
The Patient Account Rep III position requires knowledge of all Medi-Cal, Cal-optima, Medicare & Managed care contracts to review all payments received. This position is also required to identify research and prepare insurance refunds to ensure accurate reimbursements. The Patient Account Rep III works under the direction of the Hospice A/R Manager to coordinate all financial aspects of patient admissions, and visits to include Benefits, insurance verification, pre- certification information, authorization, and patient's change of insurance process. To encompass all payer types. Assures Insurance information is accurate. Knowledge of insurance payor types
INDH
Patient Account Representative
Position Type: Full time- On-site
Schedule: M-F, 8:00 am - 4:30 pm
Pay: $26- $31 an hour based off experience related to the position
DESCRIPTION
The Patient Account Rep III position requires knowledge of all Medi-Cal, Cal-optima, Medicare & Managed care contracts to review all payments received. This position is also required to identify research and prepare insurance refunds to ensure accurate reimbursements. The Patient Account Rep III works under the direction of the Hospice A/R Manager to coordinate all financial aspects of patient admissions, and visits to include Benefits, insurance verification, pre- certification information, authorization, and patient's change of insurance process. To encompass all payer types. Assures Insurance information is accurate. Knowledge of insurance payor types
- Reviews and identifies all Medicare, Medi-Cal, Cal-Optima and managed care payments accurately.
- Calculates Medicare, Medi-Cal, Cal-optima, and Managed care adjustments accurately and in a timely manner
- Assess denied services and apply contract knowledge to determine proper preventive measures
- Identifies insurance refunds accurately and sends Inquiries to insurance company in a timely manner
- Accurately documents telephone calls in MCHPS system and answers Correspondence in a timely manner
- Process and pay all invoices in a timely manner while effectively interacts with A/P staff to keep records and up to date
- Complete end-of-month closing and statistical reports and ensure that charges and payments are balanced and Process additional development requests (ADRs)
- Bill Medicare, Medi-Cal and all private payers in a timely manner while maintaining low Accounts Receivable days
- Verifies insurance for all Payers types, for all homecare and hospice admissions and documents in EMR
- Obtain and track all necessary Pre- certification and pre-authorization from all payer types and document in EMR
- Functions as a liaison between insurance case manager, clinician, and the clinical supervisor
- Ensure timely, accurately filing of All NOEs into DDE within timely filing assigned by CMS
- Ability to be at work and be on time and follow company policies, procedures and directives
- Ability prioritize and multitask while maintaining a positive and constructive manner
- Other duties as assigned
- Previous hospital billing experience including knowledge of commercial, government and managed care insurance required
- Knowledge of Billing and follow-up procedures
- Knowledge of Medicare, Medi-Cal and Cal-Optima are a plus
- Experience in Typing and use of 10-key calculator
- Knowledge of Microsoft Office Suite
- Excellent customer service, dealing with clinicians and families
INDH
Source : Alura Workforce Solutions
