Billing & Collections Representative II - PFS - RCSSD
Job Summary
The Billing & Collections Representative II (BCII) under the direction of the Manager Professional Billing & Coding, is responsible for resolving outstanding balances from various payors including Commercial, Medi-Cal, and Managed Care professional claims. This includes checking claim statuses through various means, providing necessary documentation, and accurately analyzing denials to ensure correct claim adjudication.
Responsibilities
- Check status of unpaid claims by telephone, website, or other means
- Process claims according to contractual arrangements with payors
- Analyze denials, review patient accounts, EOBs, and RA codes, and take corrective actions as needed
- Report problematic payor trends to leadership with specific examples
- Forward unresolved claims to leadership for further review and resolution
- Follow up on assigned work queues and complete documentation in accordance with standards
- Review and correct payor/clearing house rejections to ensure claim adjudication
- Comply with federal, state, and local regulatory collection guidelines, as well as department and payor-specific billing guidelines
Requirements
- High School Diploma/GED or equivalent
- Minimum of 2 years of relevant experience
- Strong verbal and written communication skills
- Problem-solving abilities
- Master negotiation skills
- Attention to detail
Preferred Qualifications
- 3 years of relevant experience
- EPIC experience
Benefits
Rady Children’s Hospital offers competitive compensation that is both externally and internally equitable. The current salary range for this position is $23.10 to $31.77. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity.