Remote Insurance Follow-Up Representative (Medi-Cal)

Description

A Remote Insurance Follow-Up Representative (MediCal) will be responsible for all collection functions for hospital and physician services. This primary responsibility of this position is account resolution which includes the following duties: reviewing accounts, following up with Medi-Cal and various insurance companies on claim status, gathering and submitting any missing... information, rebilling, appeals, and billing out secondary electronic or paper claims to all payers as needed.

Duties/Responsibilities
? Provide customer service to various healthcare contract customers
? Prepare, research and collect from Medi-Cal and various contracted health insurance payers
? Research remits and Explanation of Benefits (EOBs) for complete accurate payments or denials
? Provide or arrange for additional information when needed
? Submit corrected claims or appeals
? Request appropriate adjustments, when required
? Identify items that require client assistance
? Gather payor trends and provide feedback
? Other duties as assigned

Required Skills/Knowledge
? Medi-Cal experience required
? EPIC experience preferred
? Microsoft Office
? Knowledge in government and non-government billing guidelines for facility/physician
? Knowledge in account/claim status, resolution, and appeals process
? Knowledge of the UB04 and HCFA forms
? Excellent customer service and time management skills
? High attention to detail required
? Excellent verbal, written, and electronic communication skills required

Education/Experience
? High school diploma or General Education Development (GED) certificate required
? One to Two years of college preferred
? Minimum of three years of experience preferred
? Prior medical billing and insurance collections or healthcare revenue cycle experience preferred

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