Pride Health is hiring a Medical Biller to support our client’s medical facility based in Costa Mesa, California .This contract opportunity is a great way to start working with a top-tier healthcare organization!
Responsibilities:
- Act as the account representative for Hoag, working with insurance companies, government payors, and patients to resolve payments and accounts.
- Complete assigned accounts and ensure maximum reimbursement by evaluating claims at contract rates (APC, DRG, APRDRG).
- Initiate appeals for underpayments and follow timely requirements to secure reimbursement.
- Review and respond to payor and patient correspondence in a timely manner.
- Escalate accounts requiring appeals due to billing, coding, or underpayment issues.
- Report new billing edits for review and resolution.
- Understand Revenue Cycle processes, managed care contracts, and payor rates, including Federal and State requirements.
- Interpret Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) for correct payment.
- Understand hospital billing forms (UB04, HCFA 1500) and how various payors process claims.
- Use patient accounting systems and document all actions in the appropriate systems.
- Assist patients with payment arrangements when needed and review applicable discounts or cash rates.
- May handle bankruptcy or deceased patient accounts.
- Perform other related duties as assigned
Qualifications:
- One year of previous hospital business experience, or equivalent required or strong background in customer service.
- Basic experience with insurance plans, hospital reimbursement methodology, and/or ICD10 and CPT coding.
Additional Information:
Location: Costa Mesa, CA
Job Type: Local/Contract
Schedule: Monday to Friday, 8:00 AM - 4:30 PM
Pay Range: $19/ hour to 29/ hour
*Offered pay rate will be based on education, experience, and healthcare credentials.
Pride Health provides a comprehensive benefits package, including medical, dental, and vision insurance, flexible spending accounts, company-paid life and long-term disability insurance, and optional supplemental life insurance for employees, spouses, and children. Additional perks include short-term disability, accident and critical illness coverage, identity theft protection, a 403b retirement plan, and tuition reimbursement of up to $4,000 annually for full-time employees.
Interested? Apply now!
About Pride Health
Pride Health is Pride Global's healthcare staffing branch, providing recruitment solutions for healthcare professionals and the industry at large since 2010.
As a minority-owned business that delivers exceptional service to its clients and candidates by capitalizing on diverse recruiting, account management, and staffing backgrounds, Pride Health's expert team provides tailored and swift sourcing solutions to help connect healthcare talent with their dream jobs. Our personalized approach within the industry shines through as we continue cultivating honest and open relationships with our network of healthcare professionals, creating an unparalleled environment of trust and loyalty.
Equal Employment Opportunity Statement
As a certified minority-owned business, Pride Global and its affiliates - including Russell Tobin, Pride Health, and Pride Now - are committed to creating a diverse environment and are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics. #GlobalDeliveryTravel