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Robert Half Medical Biller/Collections Specialist in Laguna Hills, California

Description

A Medical Laboratory in Orange County is in the need of a Medical Billing Collections Specialist. The Medical Billing Collections Specialist will perform collections and medical billing for various regional and national payers, including Federal, State, Third Party (HMO, PPO, IPA, TPA Indemnity) and Patient Billing.

Duties

• Insurance Billing and Insurance Collections. Reviewing patient statements and working closely with patients to collect on open balances.

• Review/update demographics and patient information for accuracy.

• Working knowledge of appropriate coding systems; CPT, ICD-10 and HCPCS, coverage; LCD/NCD and reimbursement associated with such codes.

• Processing, validation of payer requests and processed claims via correspondence, remittance advice and EOBs (i.e., identification of payment discrepancies, inappropriate requests)

• Investigate all denied services to determine the reason for the service denial, appeal, if appropriate. Identify and report root causes associated with denials.

• Timely, effective processing of assigned appeals including development, submission, tracking, reporting and evaluation of appeal outcomes (i.e., next steps, improved outcomes)

• Maximize utilization of Billing system, tools, and resources to support cash collection activities.

• Review and work various reports including aging, adjustments, and credit balances.

• Comply with Federal and State legislation pertaining to all billing related matters.

Requirements CMS 1500, Medical Billing, Medical Collections

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