Job Summary: Sr. Medi-cal Biller is responsible for all Medi-cal billing of accounts to Fiscal Intermediary (FISS) to ensure that PFS is capturing all revenues as timely, efficiently and accurately as possible. The Medi-cal Biller, Senior utilizes many complex and varying regulations, guidelines and systems to perform Medi-cal billing functions. Proactively works with Fiscal Intermediary, patients and in-house resources to identify and resolve issues that delay account billing. Works under the supervision of management performing all tasks related to hospital reimbursement.
Duties & Responsibilities:
Utilize patient billing software in performance of job functions.
Accurately and timely request documentation needed from other departments to complete the billing process.
Apply working knowledge of coding for accurate, timely billing reimbursement.
Demonstrates appropriate follow-up necessary resulting in expedient payment of billed charges.
Ability to recognize, share and apply knowledge of state and federal regulations in Medi-cal billing activities.
Able to be at work and on time, follow organization rules and procedures and directions from a Coordinator or other member of the Management staff.
At all times, provides professional and exceptional customer service and sets an example when interacting with all customers.
Able to adhere to all confidentiality policies and procedures and carries out all tasks in a pleasant and respectful manner.
Ability to make suggestions for and initiate enhancements throughout the department and continually seeks opportunities to improve current policies, procedures and practices.
Able to recognize and perform essential duties and offers assistance to others or performs other required tasks when own assignments are completed. Performs other duties as assigned by management.
Ability to use critical thinking while reviewing Medi-cal billing and collection notes in the financial computer system to ensure that the appropriate action is taken within the billing and collection process and to ensure correct hospital reimbursement.
Responds to insurance/departmental inquiries timely, effectively and accurately according to policies and procedures.
Documents all communications and patient/insurance demographics in the financial system ensuring detailed accuracy and necessary information to provide follow-up.
Working knowledge of HCPCS, CPT, ICD and revenue codes using appropriate manuals and resources, both hard-copy and online to facilitate billing.
Accurately and timely prepares and keys electronic and hard-copy billing; working rejects and other electronic reports daily; assists others, as requested.
Meets productivity goals as set by Management.
Knowledge of and appropriately applies state and federal regulations in Medi-cal billing activities using manuals and resources, both hard-copy and online, to initiate billing.
Makes suggestions for enhancements throughout the department and continually seeks opportunities to improve current policies, procedures and practices.
Recognizes and performs essential duties and offers assistance to others or performs other required tasks, as assigned by management, when own assignments are completed.
Experience and Qualifications:
Minimum 3 year of experience and understanding of Medi-cal hospital billing processes, required
Excellent interpersonal skills, required
Positive work ethic
Able to work independently
Written and verbal communication skills to meet productivity standards
Knowledge of medical terminology and coding
Ability to effectively communicate
Microsoft Office experience, preferred
Use of 10-key calculator by touch, preferred
High school diploma or GED equivalent required
Hospital billing courses, highly preferred
Internal Number: MEM003544
Let us introduce ourselves. We're MemorialCare, a nonprofit health system that includes four hospitals, two medical groups, imaging centers, surgical centers and much more. As one of the leading health systems in Orange County and Los Angeles County, we're confident that no matter what your needs are, we have the teams, tools and know-how to support you every step of the way.