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Collections Representative
Ref No.: 18-00923
Location: Emeryville, California
1.        Secure all forms and pertinent information for billing (i.e., medical records reports, DOFRs, EOBs, R/A's, COB information, departmental reports, authorizations, precertifications, TARs, MSP forms, UPIN/PIN #'s, physician license #'s, consents, and other information as required).  
 
2.               Review all bills and accounts for accuracy, completeness, and compliance with all local, state, and federal requirements (i.e., diagnosis codes, procedure codes, UB codes, UB92 claim completion, charges, billing information, etc.).     
 
3.               Sort hardcopy bills stratified by dollar amount.  
 
4.               Submit bills to payers in a timely and stratified manner in accordance with department and payer requirements.    
 
5.               Enter detailed on-line notes as to where, when and dollar amount billed providing an audit trail for future follow up.  
 
6.               Complete billing WIP, activity reports and batch QUIC logs as required.  
 
7.               Work error reports and transmit corrections on electronically submitted claims as required. 
 
8.               Bill secondary insurance as required.  
 
9.               Check on-line contract information as required.  
 
10.            File appeals and contact the managed care department as required.  
 
11.            Secure guarantor/patient demographic and/or insurance information as required.  Update the on-line system with accurate and complete information.  
 
12.            Inform appropriate parties according to established guidelines of CPT4/HCPCS coding problems, incorrect UB codes, incorrect insurance plan codes, addresses, and compliance issues as required. 
 
13.            Check on-line systems for eligibility and/or benefit verification (i.e. DDE, CERTS, POS, Share of Cost, etc.) including claim status from payer websites. 
 
14.            Maintains a thorough working knowledge of billing procedures per established office policies, county, state and federal regulations.  
 
15.            Enter accounts with deficiencies on the appropriate QUIC lists for accountability and management.  Maintains current status by updating, deleting, adding and tracing aged accounts with responsible entities.