The Insurance Follow-Up Representative (Medi-Cal) will be responsible for all collection functions for hospitaland 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