Kentucky
O'Fallon, Missouri
Durham, North Carolina
Posted: 13-Mar-23
Location: Downey, California
Salary: Open
Categories:
Internal Number: 17833
PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Hospital - Whittier, PIH Health Hospital - Downey and PIH Health Good Samaritan Hospital, 27 outpatient medical locations, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, women’s health, urgent care and emergency services. The organization is recognized by Watson Health as one of the nation’s Top Hospitals, and College of Healthcare Information Management Executives (CHIME) as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. PIH Health is certified as a Great Place to Work TM. For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.
Under the supervision of the Commercial Supervisor, this position is responsible for the timely and accurate follow up of Commercial and Government HMO insurance Accounts Receivable. This consists of contacting the appropriate responsible payer for the status of submitted claim(s) and resolution of delays in payment or underpayments of the contracted amount due to Presbyterian Intercommunity Hospital for its services rendered. Responsible for interpreting contracts to calculate expected reimbursement, identifying additionally reimbursed contract carve outs, and submitting appropriate contractual adjustments and write-offs. Meet and exceed the minimum productivity volume, and standards of work as defined within the departmental policies and procedures.
- Demonstrated ability to utilize personal computer, 10-key adding machine, calculator, fax machine, copier and scanners.
- Able to multi-task, good mathematical skills, excellent verbal and written communication skills, sound decision making.
- Ability to learn new systems, and extract data from hospital systems.
- Proficient in Microsoft Excel and Word.
- High school graduate preferred.
- Two years college preferred.
- Must have a minimum of two (2) years experience in hospital Commercial Follow up and/or Billing.
- Knowledge of Insurance and Government Billing guidelines and regulations.
- Evidence of continuing education preferred.
- Understanding of Medicare CMS rules and regulations related to accurate claims submission.
Beyond the benefits that come with working for the area's leading community healthcare provider – one that also recognizes the need to ensure patient safety and comfort – you'll enjoy an extremely competitive compensation and benefits package. We are an equal opportunity employer and seek diversity in our workforce. EOE M/F/D/V
