Remote Insurance Follow-Up Representative (Medi-Cal)
Description:
Job Description
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
Requirements: