Hoag
Salary Range:
$24.10 - $37.05/hour. Actual compensation may vary based on geographic location, work experience, skill level, and education. Job Responsibilities:
Serve as the account representative for Hoag, working with insurance companies, government payors, and patients to resolve payments and accounts. Complete assigned accounts within work queues, obtaining maximum reimbursement by evaluating claims using contract management tools. Review and initiate appeals for underpayments, ensuring timely submission to secure reimbursement. Handle payor and patient correspondence promptly, escalating accounts as needed for improper billing or underpayments. Report billing edits to supervisors for review and resolution. Maintain a strong understanding of Revenue Cycle processes, managed care contracts, payor rates, and relevant regulations. Interpret Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to ensure proper payment. Assist and educate patients and colleagues about benefit plans and billing forms (UB04, HCFA 1500). Possess knowledge of various payors (HMO, PPO, Medicare, Medi-Cal, etc.) and claim processing procedures. Use patient accounting systems effectively, document calls and actions, and accurately code insurance plan information. Establish payment arrangements with patients when necessary, including reviewing applicable rates and discounts. Process bankruptcy and deceased patient accounts as applicable. Perform other duties as assigned, meeting productivity and quality standards. Assist peers and supervisors with escalated issues, participate in training, and recommend process improvements. Qualifications:
High school diploma or equivalent required. Minimum of five years' experience in a hospital or related medical field. Working knowledge of Epic Resolute, Epic Cerner, Epic CPOE, and reporting tools. Proficiency in MS Excel. Highly detail-oriented with strong organizational and prioritization skills. Hoag is an Equal Opportunity Employer committed to diversity and a discrimination-free work environment.
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$24.10 - $37.05/hour. Actual compensation may vary based on geographic location, work experience, skill level, and education. Job Responsibilities:
Serve as the account representative for Hoag, working with insurance companies, government payors, and patients to resolve payments and accounts. Complete assigned accounts within work queues, obtaining maximum reimbursement by evaluating claims using contract management tools. Review and initiate appeals for underpayments, ensuring timely submission to secure reimbursement. Handle payor and patient correspondence promptly, escalating accounts as needed for improper billing or underpayments. Report billing edits to supervisors for review and resolution. Maintain a strong understanding of Revenue Cycle processes, managed care contracts, payor rates, and relevant regulations. Interpret Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to ensure proper payment. Assist and educate patients and colleagues about benefit plans and billing forms (UB04, HCFA 1500). Possess knowledge of various payors (HMO, PPO, Medicare, Medi-Cal, etc.) and claim processing procedures. Use patient accounting systems effectively, document calls and actions, and accurately code insurance plan information. Establish payment arrangements with patients when necessary, including reviewing applicable rates and discounts. Process bankruptcy and deceased patient accounts as applicable. Perform other duties as assigned, meeting productivity and quality standards. Assist peers and supervisors with escalated issues, participate in training, and recommend process improvements. Qualifications:
High school diploma or equivalent required. Minimum of five years' experience in a hospital or related medical field. Working knowledge of Epic Resolute, Epic Cerner, Epic CPOE, and reporting tools. Proficiency in MS Excel. Highly detail-oriented with strong organizational and prioritization skills. Hoag is an Equal Opportunity Employer committed to diversity and a discrimination-free work environment.
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