Medical Biller
PFS Billing
Travel Required : None
Clearance Required : None
What You Will Do :
The Medical Biller is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to facilitate the meeting of both departmental and facility goals and objectives. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers.
Has an extensive knowledge of billing requirements mandated by payers and / or governmental regulations. This position will perform any and all related job duties as assigned.
The medical biller will be working a hybrid schedule of two days at either the San Marcos, CA or El Segundo, CA offices and three days from home.
Essential Job Functions :
- Hospital Billing Emphasis
- Correcting and billing electronic and hardcopy claims
- Submits adjusted claims
- Provides follow-up billing
- Prepares billing reconciliation
Duties and Responsibilities :
Performs daily download and reconciliation of claims from patient accounting system to electronic billing systemTransmits or releases claims at a minimum dailyWorks all assigned claims daily by resolving edits, validating claim, or placing on departmental hold by reasonFollows-up on all assigned held claims or unreleased claimsBills claims via electronic billing systemReviews same day and 72 hour admission report to determine if accounts needed to be combinedEnsures all address changes and / or plan changes are forwarded to the appropriate people so the integrity of the insurance master is maintainedFiles adjusted billings based on audits and / or changes in diagnosis or DRGUpdates patient accounts with corrected demographic or insurance informationWorks all rejection and payer audit reports within 48 hours of receipt taking whatever action may be required to obtain account resolutionMonitors all denials for trends and issues and reports finding to supervisorBills or re-bills as necessaryEnsures hospital is in compliance with all state and federal rules and regulations both billing and HIPAAAssigned special projects will be completed within the time frames givenAppropriately documents electronic billing system and / or patient accounting systemAttends training sessions and seminars offered by the Hospital and Third Party PayersHandles all customer calls both internal and external in a professional and courteous mannerReturns calls and emails as soon as possible, but must be returned within 24 hoursFollows the mission statement and values established by the facilityWhat You Will Need :
High School Diploma / GED or 3 years of relevant equivalent experience in lieu of diploma / GED.0-2+ years working within the following sectors : healthcare, insurance, business, finance or customer service.Working knowledge can be of the following : insurance claims, billing, coding, follow-up, finance, accounting or customer service related responsibilities.What Would Be Nice To Have :
Previous billing background.Emphasis in Hospital BillingExcellent communication and interpersonal skills.Experience with Excel and Word.The annual salary range for this position is $38,000.00-$63,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
What We Offer :
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Medical, Rx, Dental & Vision InsurancePersonal and Family Sick Time & Company Paid HolidaysPosition may be eligible for a discretionary variable incentive bonusParental Leave401(k) Retirement PlanBasic Life & Supplemental LifeHealth Savings Account, Dental / Vision & Dependent Care Flexible Spending AccountsShort-Term & Long-Term DisabilityTuition Reimbursement, Personal Development & Learning OpportunitiesSkills Development & CertificationsEmployee Referral ProgramCorporate Sponsored Events & Community OutreachEmergency Back-Up Childcare ProgramAbout Guidehouse :
Guidehouse is an Equal Opportunity EmployerProtected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com.
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com.
Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.