Patient Account Rep Medi-Cal Medi-Cal Managed Care Billing/Follow Up, PIH Health Good Samaritan, Full Time, Day Shift
Location: Los Angeles, California
Mental Health/Social Services
Internal Number: 16021
PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Hospital - Whittier, PIH Health Hospital - Downey and PIH Health Good Samaritan Hospital, 27 outpatient medical locations, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, women’s health, urgent care and emergency services. The organization is recognized by Watson Health as one of the nation’s Top Hospitals, and College of Healthcare Information Management Executives (CHIME) as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. PIH Health is certified as a Great Place to Work TM. For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.
Under the supervision of the Government Billing Manager, this position is responsible for the timely and accurate billing through resolution of Medi-Cal/Managed MediCal inpatient and outpatient accounts. This includes billing, collection and follow-up activities; identification and processing of appropriate write-offs, accurate resolution of all credit balances and prompt response to communications from Medi-Cal/Managed Medi-Cal Health Plans. Ensures compliance to Medi-Cal billing requirements to include all coding edits. Performs timely billing of Medi-Cal as a secondary insurance to Medicare Part B and Commercial Insurance. Meet and exceed the minimum productivity volume, and standards of work as defined within the departmental policies and procedures.
Demonstrated ability to use a 10-key adding machine, calculator, fax machine, photocopy machine keyboard for data entry and personal computer (PC). Ability to perform multiple tasks, good mathematical skills, sound decision making abilities and good verbal and written communication skills. Ability to learn new systems, become proficient in development of reports via hospital systems and tools provided, proficient in excel and word document for appeal submission to payers.
High school graduate
Two year’s college preferred. Minimum two years in hospital Medi-Cal and Medi-Cal Manage Care billing and follow up required. Knowledge of Medi-Cal billing requirements and regulations. Evidence of continuing education preferred. Familiarity with commercial third party billing requirements. AllScripts/SFM, NThrive/Claims Manager preferred, but not required.
Beyond the benefits that come with working for the area's leading community healthcare provider – one that also recognizes the need to ensure patient safety and comfort – you'll enjoy an extremely competitive compensation and benefits package. We are an equal opportunity employer and seek diversity in our workforce. EOE M/F/D/V