Job Information
Robert Half Lead Medical Collections Specialist in Arcadia, California
Description
A Hospital Network near Pasadena is in the need of a Lead Medical Collections Specialist with Managed Care experience. The right person for this role must have 5+ years of experience in Hospital revenue cycle. The Lead will provides full cycle insurance billing and collections.
DUTIES AND RESPONSIBILITIES
· Performs full cycle billing and collection functions for facilities fees
· Verify patient eligibility, authorization status and primary payer information via CareConnect and Insurance portals prior to claim submission
· Performs all data entry and charge posting functions for services as needed.
· Performs all third party follow-up functions for all products and inpatient procedures.
· Reviews EOBS and Denials. Make corrections as required and resubmit the claim for payments
· Performs daily review of Urgent Care provider chart notes to assure that documentation is complete and supportive of submitted charges prior to billing.
· Provides the correct ICD-10M code to identify the provider's narrative diagnosis
· Provides the correct HCPCS code to identify medications and supplies
· Provides the correct CPT code to accurately identify the services performed based on the provider's documentation.
Requirements
UB04, In Patient Insurance Collections, Medical Collections, Insurance AR follow up
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