Sr., Patient Account Biller (Medi-Cal Biller)

Location: 
MCSS-MemorialCare Shared Svcs
Schedule: 
Full Time
Shift: 
Day Job
Job Listing: 
MEM003544
Patient Financial, Claims, Billing
Job Summary:
Sr. Medi-cal Biller is responsible for all Medi-cal billing of accounts to Fiscal Intermediary (FISS) to ensure that PFS is capturing all revenues as timely, efficiently and accurately as possible. The Medi-cal Biller, Senior utilizes many complex and varying regulations, guidelines and systems to perform Medi-cal billing functions. Proactively works with Fiscal Intermediary, patients and in-house resources to identify and resolve issues that delay account billing.  Works under the supervision of management performing all tasks related to hospital reimbursement.
Duties & Responsibilities:
  • Utilize patient billing software in performance of job functions.
  • Accurately and timely request documentation needed from other departments to complete the billing process.
  • Apply working knowledge of coding for accurate, timely billing reimbursement.
  • Demonstrates appropriate follow-up necessary resulting in expedient payment of billed charges.
  • Ability to recognize, share and apply knowledge of state and federal regulations in Medi-cal billing activities.
  • Able to be at work and on time, follow organization rules and procedures and directions from a Coordinator or other member of the Management staff.
  • At all times, provides professional and exceptional customer service and sets an example when interacting with all customers.
  • Able to adhere to all confidentiality policies and procedures and carries out all tasks in a pleasant and respectful manner.
  • Ability to make suggestions for and initiate enhancements throughout the department and continually seeks opportunities to improve current policies, procedures and practices.
  • Able to recognize and perform essential duties and offers assistance to others or performs other required tasks when own assignments are completed.  Performs other duties as assigned by management.
  • Ability to use critical thinking while reviewing Medi-cal billing and collection notes in the financial computer system to ensure that the appropriate action is taken within the billing and collection process and to ensure correct hospital reimbursement.
  • Responds to insurance/departmental inquiries timely, effectively and accurately according to policies and procedures.
  • Documents all communications and patient/insurance demographics in the financial system ensuring detailed accuracy and necessary information to provide follow-up.
  • Working knowledge of HCPCS, CPT, ICD and revenue codes using appropriate manuals and resources, both hard-copy and online to facilitate billing.
  • Accurately and timely prepares and keys electronic and hard-copy billing; working rejects and other electronic reports daily; assists others, as requested.
  • Meets productivity goals as set by Management.
  • Knowledge of and appropriately applies state and federal regulations in Medi-cal billing activities using manuals and resources, both hard-copy and online, to initiate billing.
  • Makes suggestions for enhancements throughout the department and continually seeks opportunities to improve current policies, procedures and practices.
  • Recognizes and performs essential duties and offers assistance to others or performs other required tasks, as assigned by management, when own assignments are completed.
Qualifications: 
Experience and Qualifications:
  • Minimum 3 year of experience and understanding of Medi-cal hospital billing processes, required
  • Excellent interpersonal skills, required
  • Positive work ethic
  • Able to work independently
  • Written and verbal communication skills to meet productivity standards
  • Knowledge of medical terminology and coding
  • Ability to effectively communicate
  • Microsoft Office experience, preferred
  • Use of 10-key calculator by touch, preferred

Education:

  • High school diploma or GED equivalent required
  • Hospital billing courses, highly preferred
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