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Experience in outpatient billing/pre-authorization or insurance verification with demonstrated knowledge of health insurance plans including: Medicare, Commercial HMO and PPO required. Immediate Supervisor Title: Billing Manager.
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Knowledge of HMO, POS, PPO, EPO, IPA, Medicare Advantage, Covered California (Exchange), capitation,commercial and government payors (i.e. Medicare, Medi-Cal, TriCare, etc) and how these payors process claims.
$22 - $30 an hourFull-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Must have strong knowledge of medical insurance billing and collections with CPT, ICD10, and HCPC coding and medical terminology as well as an overall understanding of managed care products (HMO, PPO, ACO, MCO.etc.
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HSA and PPO insurance with HSA or FSA options (Blue Cross Blue Shield) As an Insurance Billing/ AR Follow-Up Specialist you are responsible for the maximization of reimbursement by contacting insurance carriers and/or 3rd parties on a daily basis to collect outstanding insurance balances due, resolve disputes and denials and general non-payment issues.
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This role requires close collaboration with our Billing Manager, Health Information Specialist, Intake Coordinators, Patient Care Coordinators, Patient Service Specialists, Staffing Coordinators, Clinic Managers, and all Clinicians.
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Knowledge in self-pay collections, third party carrier billing guidelines; commercial insurance/contracts, HMO, PPO, Medicare, Medi-Cal, CHAMPUS-TRICARE, CMS, GHPP, CCS billing. Oversight of clinic areas such as practice revenue management, billing systems, and procedures, tracking product inventory, facilities and safety procedures, registration, new patient coordination, scheduling, medical records storage and maintenance, insurance authorizations.
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Knowledge of PPO, HMO, IPA, MSO, and Medi-Cal billing practices & protocols. 2+ years of recent third-party billing/coding/collections and/or Revenue Cycle process experience. Identify and resolve patient billing complaints.
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Strong knowledge of medical insurance billing and collections with CPT, ICD9, and HCPC coding and medical terminology, as well as an overall understanding of managed care products (HMO, PPO, etc.
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Initiates Prior Authorization submissions and completes all follow ups for all insurance Payors including Medicare Advantage, Medicaid's, HMO, PPO, and Commercial until the case has reached a determination.
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As the Contract Specialist, Provider, you will be responsible for supporting provider contracts for all lines of business; Commercial, Medicare Advantage, Medi-Cal HMO and PPO. As part of a cross-functional team, you will work directly with the Contracting Team, Finance, Medical Services, Claims, Configuration, Network Management, Customer Service, Legal, Compliance and our valued providers.
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Additional Responsibilities: High Volume inbound call center environment for self-pay customer service related to Hospital and Physician billing. Has a strong understanding of the Revenue Cycle processes, from Patient Access (authorizations & admissions) through Patient Financial Services (billing & collections), including procedures and policies.
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Manages, coordinates, and directs all aspects of medical offices for the medical clinic including all business office operations I.T., patient scheduling, records, billing, communications, personnel administration, material control, including OSHA, CLIA and other regulatory criteria, and all other related activities to meet practice objectives.
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This role is responsible for daily agronomy related accounting functions including billing seed, chemical and fertilizer as well as accounting functions related to customer billing and account reconciliation.
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Dental Coverage: The City offers two (2) dental options thorugh Delta Dental: HMO & PPO. Prepares, processes, and reviews various documents, including but not limited to purchase requisitions and orders, billing invoices, accounts payable and payroll documents, disbursement statements, check requests, quote sheets, vendor applications, fixed asset forms, various reports and spreadsheets.
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In depth knowledge of health care insurance systems, which may include Medi-Cal, MediCare, HMO, PPO, fee-for-service, county funded coverage, and worker's compensation, sufficient to properly obtain and track authorizations, appoint patients, make referrals for consults, diagnostics and ancillary services, coordinate hospital services, complete and submit billing documentation, and explain provisions and requirements to patients.
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