Collections-Follow Up Representative
Emeryville Emeryville, CA 94608
Job Title: Collections – Follow Up Representative
Location: Emeryville, CA - 94608
Duration: 4+ Month contract (Higher Possibility to Extend)
About Client: Our client serves the local, regional and global communities by forming strategic alliances and developing strong partnerships to improve health, enhance opportunities for education and foster research collaborations around the world.
- Analyze and interpret the various managed care contracts via Contract Matrix Grid to ensure compliance with the terms and conditions when calculating expected reimbursement.
- Should perform expected reimbursement override and update it.
- Ensure correct payer/plan codes are utilized in accordance with managed care contracts and notifies management of needed changes.
- Responsible for ensuring correct payer/plan codes are utilized in accordance with managed care contracts, appropriate authorizations, pre-certifications are on file and appropriately documented on the UB04 and/or on-line systems.
- Responsible for monitoring current status of billing and collections using RFI workqueues.
- Should gather all forms and pertinent information necessary for filing appeals (i.e., medical records reports, denials, EOBs, R/A’s, COB information, departmental reports, authorizations, pre-certifications, as required).
- Responsible for processing all payer denials by conducting follow up with payers regarding non-payments, underpayments, or incorrect payments and entering detailed account notes in EMR system.
- Should utilize APEX Smart Text Letter for recording and filing all Provider Disputes for appeal.
- Should maintain current status of accounts by processing late charges, credits, corrected billings, contractual adjustments or escalates to management.
Required Experience And Certification:
- Should have a high school diploma or GED with at least 1-3 years experience in a hospital billing office environment.
- Should have ICD9, CPT4, HCPCS, DRG coding experience.
- Should have Hospital Collection, Uniform Billing (UB04/UB92) and Commercial Insurance experience.
- Good to have EPIC experience.
- Should have knowledge of contracts, insurance billing requirements, UB92 claim forms, Worker’s Compensation, HMOs, PPOs, capitation, Medicare, Medi-Cal and compliance program regulations.
- Should have knowledge of electronic billing systems (i.e. NEIC, Cirius, WebMD, Envoy, etc.).
- Should have a strong understanding of stop losses, per diems, carve outs and other contract terms and conditions.
- Should have experience with medical terminology and understand HIPAA rules and regulations.
- Should have strong communications skills and PC skills.
About ASK: ASK Staffing is an award-winning technology and professional services recruiting firm servicing Fortune 500 organizations nationally. With 5 nationwide offices, two global delivery centers, and employees in 42 states-ASK Staffing connects people with amazing opportunities.
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