Randstad Billing Specialist in San Jose, California
San Jose, CA
Saturday, October 15, 2016
Randstad Finance & Accounting
Billing Specialist - San Jose, CA.
Essential Duties :
Review Government and Non-Government Payer claims for accuracy, completeness and compliance with payer requirements.
Serve as back up to review encounters using daily reports, and communicating to the health centers when information is needed to bill the encounters.
Process pharmacy claims utilizing claims editing software.
Work accounts receivable report to ensure timely follow up is performed including but not limited to: researching and determining the cause of the denial, rebilling or contacting payers via phone, website, RTD, CIF, Tracer or formal Provider Dispute process to resolve payment, denial and billing issues.
Address questions from health center staff regarding issues which may include but are not limited to patient eligibility, data entry, coding and other payer requirements.
Address questions from patients regarding insurance or refunds
Work credit balance and unapplied credit report, processing insurance and patient refunds.
QUALIFICATIONS & REQUIREMENTS:
Ability to perform the above duties. A typical means of acquiring these abilities would be:
High School Diploma and three to five years of experience in Medical Billing and Collections required.
Three to five years of current Practice Management System experience preferred.
In depth knowledge of Government and Non-Government payer sources and demonstrated proficiency in the interpretation of carrier contracts.
Knowledge of CPT4/ICD9/HCPCS codes.
Strong oral and written communication skills
Proficiency in Microsoft Office Suite with excellent knowledge of Microsoft Excel.
Multi-tasking and attention to detail is required.
Research skills to interpret new medical and insurance industry terminology
Ability to resolve problems with rejected or disputed claims.
Ability to effectively communicate with health care professionals and third-party providers on payment and claim issues.