Responsibilities

• Assists in the completion of initial and re-authorizations as needed of all HMO/CAL custodial residents, including pertinent documentation necessary for approval.
• Keeps accurate and necessary tracking system for Authorizations needed.
• Completes Authorizations timely and follow up for approval.
• Submits claims for HMO/CAL's, including follow up, phone calls and Appeals.
• Researches and follows up on HMO claims as assigned by the Office Manager and Bookkeeper, i.e. Claims submission, Appeals, follow up and correspondence; accountability to the Business Office Manager/Bookkeeper for the assigned accounts with oral and written reports of action taken.
• Assists in the Collection Process of all private accounts, including phone calls, collection letters and the policy and procedure for collections. Keeps accurate documentation on all phone calls.
• Performs assertive functions as necessary or directed, i.e. letters, phone calls, photocopying, etc.
• Covers for receptionist during their breaks and lunch or whenever needed.
• Engages in cross training for all business related services.

Requirements

• Medical insurance billing experience or education
• Healthcare office experience (preferred)
• Medi- Cal and Medicare billing knowledge is a plus
• Must possess, as a minimum, a high school diploma or GED.
• Ability to effectively communicate with other departments in the facility
• Ability to engage in frequent customer-focused interaction with residents and their families