3 jobs found in hanford

Description: Looking for a well-rounded Medical Billing Specialist. Ideal candidate will have a minimum of 2 years, strong hands on application of ICD-10, CPT, and HCPCS coding systems and E&M Auditing and Chart Auditing, as well as Medical Office Management background. Candidate must have the ability to work toward creating and maintaining good relationships with physicians, supervisors, co-workers, insurance carriers and patients. Additionally, ideal candidate will foster working as a team; dealing with and resolving conflict in a timely, efficient and positive manner and is willing to mentor and train non-billing staff about insurance and billing workflows pertinent to their particular job functions (i.e. front office, collections, eligibility, benefits and authorizations teams, etc). .Requirements: Knowledge, Skills and Abilities: 1) Knowledge and strong hands on application of ICD-10, CPT and HCPCS coding systems 2) Knowledge and strong hands on application of chart review and documentation auditing 3) Knowledge of health insurance programs, coverage offered and third-party reimbursement mechanisms, including Medicare, Medi-Cal, PPO, HMO, IPA, PMG, Military and Veteran, Workers Compensation and their billing guidelines and processes 4) Knowledge of electronic medical record systems 5) Knowledge of manual and electronic billing systems and procedures 6) Knowledge of eligibility, benefits and authorizations processes 7) Knowledge of general office procedures to create efficient and positive work environment 8) Knowledge of all health care services offered by each clinic site 9) Skill in communicating effectively to peers, supervisors and patients and to handle stressful situations appropriately 10) Skill in operating personal computer utilizing word processing, spreadsheets, databases, email and other office equipment 11) Maintains accurate and timely billing 12) Audits insurance information for appropriateness in current billing system and is able to quickly identify underpayments or other trends that may negatively affect cash flows 13) Ability to prioritize work and able to work with little or no supervision 14) Ability to communicate both verbally and written effectively and efficiently 15) Ability to maintain confidentiality of information, most importantly patient financial and medical information 16) Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form 17) Follows timely filing guidelines per payer to ensure maximum payment 18) Ability to understand and respond appropriately, effectively, sensitively to special population groups as defined by race, ethnicity, language, age, sex, etc. 19) Ability to hear and speak well enough to converse over telephone 20) Ability to see well enough to use computer efficiently and read computer reports and correspondence 21) Strong Excel, Word and Power Point skills 22) Willingness to learn, understand and abide by company policies and procedures Productivity: 1) Ensures billing of services meet standards set by medical corporation 2) Uses good judgment when auditing, preparing and billing charges to other entities for payment 3) Completion of daily, weekly and added special projects Quality Management: 1) Constantly alert for ways to improve customer service, improve patient flow, increase productivity, and improve utilization of resources communicating ideas to supervisor 2) Maintains infrequency of denials in the billing process 3) Ensures that electronic and hard copy claims are accurate and completed on time. 4) Verifies and ensures competency when utilizing EMR and Billing systems 5) Uses mathematical accuracy and attention to detail 6) Audits of invalid/rejected edits for accuracy in the electronic claims submission 7) Ensures provider correction requests are responded back to billing timely 8) Notifies supervisor of unusual occurrences and adheres to policy regarding incident forms and/or patient complaints 9) Attends and actively participates in staff meetings as requested 10) Attends and actively participates in staff trainings, webinars and seminars as requested Reliability: 1) Positively supports requests from administrative office and supervisor in implementing policy and new programs 2) Dependable and punctual Customer Service: 1) Sets the example of exemplary patient and insurance customer service 2) Responds to patient or insurance representative calls in a professional manner 3) Reviews the terms of service performed, sliding fees, third party payments and payment collection with patient via telephone 4) Ensures cleanliness of work environment during operational hours and is always prepared to provide friendly assistance to patients, insurance and staff members Lags Medical Centers are the primary musculoskeletal providers for California's Ventura County, Central Coast, Central Valley and Bay area. We use state-of-the-art diagnostics to help in creating individualized treatment plans to effectively manage and alleviate pain. We offer a comprehensive benefit package including medical, dental, vision, 401k, PTO and much more. PI117270251

Description: Looking for a well-rounded Medical Insurance Claims AR Specialist . Ideal candidate will have a minimum of 2 years strong hands on claims review and clean up, as well as application of ICD-10, CPT, and HCPCS coding systems and E&M Auditing and Chart Auditing. Candidate must have the ability to review contracts for correct reimbursement, understand how to analyze ERAs, EOBs and other information to identify underpayments, non-payments and denials and how to work through to get claims resubmitted and paid. Candidate must also be able to identify trends that can be worked as a project to help capture revenue that would otherwise be written off or lost due to timely filing delays or payer incorrect application of contractual agreements or incorrect processing of claims. We offer a comprehensive benefit package that includes medical, dental, vision, 401k , PTO, growth opportunities and much more! Lags Medical Centers are the primary care musculoskeletal provider for California's Ventura County, Central Valley, Central Coast and Bay area. We use state-of-the-art diagnostics to create individualized treatment plans to effectively manage and alleviate pain. .Requirements: Knowledge, Skills and Abilities: 1) Knowledge and strong hands on application of claims review and clean up 2) Knowledge and strong hands on application of ICD-10, CPT and HCPCS coding systems 3) Knowledge and strong hands on application of chart review and documentation auditing 4) Knowledge of health insurance programs, coverage offered and third-party reimbursement mechanisms, including Medicare, Medi-Cal, PPO, HMO, IPA, PMG, Military and Veteran, Workers Compensation and their billing guidelines and processes 5) Knowledge of various payer Provider Dispute Resolution, First and Second Level appeal processes 6) Knowledge of various payer medical necessity guidelines and/or how to obtain these 7) Knowledge in interpretation of Claims Aging and Financial Analysis Reporting 8) Knowledge of electronic medical record systems 9) Knowledge of manual and electronic billing systems and procedures 10) Knowledge of eligibility, benefits and authorizations processes 11) Knowledge of general office procedures to create efficient and positive work environment 12) Skill in communicating effectively to peers, supervisors and patients and to handle stressful situations appropriately 13) Skill in operating personal computer utilizing word processing, spreadsheets, databases, email and other office equipment 14) Audits insurance information for appropriateness in current billing system and is able to quickly identify underpayments or other trends that may negatively affect cash flows 15) Ability to prioritize work and able to work with little or no supervision 16) Ability to communicate both verbally and written effectively and efficiently 17) Ability to maintain confidentiality of information, most importantly patient financial and medical information 18) Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form 19) Follows timely filing guidelines per payer to ensure maximum payment 20) Ability to understand and respond appropriately, effectively, sensitively to special population groups as defined by race, ethnicity, language, age, sex, etc. 21) Ability to hear and speak well enough to converse over telephone 22) Ability to see well enough to use computer efficiently and read computer reports and correspondence 23) Strong Excel, Word and Power Point skills 24) Willingness to learn, understand and abide by company policies and procedures Productivity: 1) Ensures billing of services meet standards set by medical corporation, federal and/or state guidelines 2) Uses good judgment when auditing, preparing and submitting PDRs and Appeals to other entities for payment 3) Completion of daily, weekly and added special projects Quality Management: 1) Constantly alert for ways to improve customer service, improve patient flow, increase productivity, and improve utilization of resources communicating ideas to supervisor 2) Maintains infrequency of denied appeals in the AR process 3) Ensures that electronic and hard copy claims are accurate and completed on time. 4) Verifies and ensures competency when utilizing EMR and Billing systems 5) Uses mathematical accuracy and attention to detail 6) Audits of invalid/rejected edits for accuracy in the electronic claim submission process 7) Ensures provider correction requests are responded back to billing timely 8) Notifies supervisor of unusual occurrences and adheres to policy regarding incident forms and/or patient complaints 9) Attends and actively participates in staff meetings as requested 10) Attends and actively participates in staff training, webinars and seminars as requested Reliability: 1) Positively supports requests from administrative office and supervisor in implementing policy and new programs 2) Dependable and punctual Customer Service: 1) Sets the example of exemplary patient and insurance customer service 2) Responds to patient or insurance representative calls in a professional manner 3) Reviews the terms of service performed, sliding fees, third party payments and payment collection with patient via telephone 4) Ensures cleanliness of work environment during operational hours and is always prepared to provide friendly assistance to patients, insurance and staff members PI117270253

Description: Looking for a well-rounded Payment Posting Specialist. Ideal candidate has a minimum 2 years of experience posting payments/follow up, ICD-10, CPT, HCPCS coding systems and E&M Auditing. Candidate must have the ability to work toward creating and maintaining good relationships with physicians, supervisors, co-workers, insurance carriers and patients. Additionally, ideal candidate will foster working as a team; dealing with and resolving conflict in a timely, efficient and positive manner and is willing to mentor and train non-billing staff about insurance and billing workflows pertinent to their particular job functions (i.e. front office, collections, eligibility, benefits and authorizations teams, etc). Posting Medical Payments Audits insurance information for appropriateness in current billing system and is able to quickly identify underpayments or other trends that may negatively affect cash flows Will follow up with payers on denials and under payments Follows timely filing guidelines per payer to ensure maximum payment You will ensure posting of payments meet standards set by medical corporation Responds to patient or insurance representative calls in a timely and professional manner Reviews the terms of service performed, sliding fees, third party payments and payment collection with patient via telephone Maintains infrequency of denials in the billing process. Ensures that electronic and paper payments are accurate and completed timely Verifies and ensures competency when utilizing EMR and billing systems Ensures provider correction requests are responded back to billing in timely manner Notifies supervisor of unusual occurrences and adheres to policy regarding incident forms and/or patient complaints Lags Medical Centers offers a comprehensive benefit package that includes medical, dental, vision,life, 401k, PTO and much more! Lags Medical Centers is a pain management group operating throughout California, Oregon, Washington & Nevada. Since 2000, the LAGS alternative approach to pain treatments has returned patients to a healthy, active lifestyle: restoring function by minimizing pain. Lags has grown to care, at scale, for a large base of underserved (Medicaid/Medicare patients), who often experience challenges in accessing healthcare. Our 40+ clinics are ideally equipped to serve these and many other patients across 22 counties. .Requirements: We require a minimum of 2 years Payment Posting Experience. High attention to detail and excellent communication skills required. In additional we require the following: Knowledge of payment posting processes Knowledge of adjustment codes and denial reasons Knowledge of health insurance programs, coverage offered and third-party reimbursement mechanisms, including Medicare, Medi-Cal, PPO, HMO, IPA, PMG, Military and Veteran, Workers Compensation and their billing guidelines and processes Knowledge of eligibility, benefits and authorizations processes Knowledge of electronic medical record systems Knowledge of ICD-10, CPT and HCPCS coding systems Knowledge of chart review and documentation auditing Knowledge of manual and electronic billing systems and procedures Knowledge of appeals and appeals process for different payers Effective communication to peers, supervisors and patients and to handle stressful situations appropriately Ability to read and interpret explanation of payment from different payers Ability to prioritize work and able to work with little or no supervision Ability to maintain confidentiality of information, most importantly patient financial and medical information Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form Strong Excel, Word and Power Point skills Willingness to learn, understand and abide by company policies and procedures PI117270272