Senior Insurance Billing Clerk - Patient Accounting-Billing

For questions regarding this position, please contact the Recruiter listed in the supplemental information.

About the role

The County of Riverside - Riverside University Health System (RUHS) - Medical Center is seeking a Senior Insurance Billing Clerk to join their Patient Accounting-Billing team in Riverside. Under general supervision, the incumbent will perform complex account resolution, lead and train staff, and serve as a trusted resource in navigating challenging problems related to procedures, regulations, and complex accounts.

Responsibilities

• Leads and trains staff; serves as a resource for staff in resolving difficult problems relating to procedures and regulations.
• Reviews and makes follow-up determinations on denied claims, including drafting original correspondence, dispute letters, and appeals to payors for facility (hospital) billing and special programs.
• Performs complex account resolution, including checking and correcting bills for numerical accuracy, proper coding, and preparing ATPs for data entry.
• Reviews patient accounts to ensure accuracy of account information and makes required adjustments for proper billing purposes.
• Registers patients for medical services such as emergency treatment care and non-emergency walk-in treatment.
• Verifies billing accounts or insurance forms for completeness and accuracy against automated and manual records.
• Monitors accounts for payment and recommends solutions for delinquent accounts.
• Reviews patient insurance forms for accuracy and contacts patients and insurance companies to obtain treatment authorizations and verify eligibility.
• Responds to requests for account information and initiates calls to patients, insurers, and internal or external departments regarding billing and follow-up matters.
• Interprets and explains regulations, contractual language, and legal obligations to internal and external clients.
• Performs specialized and difficult fiscal clerical work in connection with processing and billing fiscal intermediaries for medical services rendered to patients.

Requirements

• Two years of experience performing fiscal, statistical, and fiscal record-keeping functions, with at least one year involving third-party intermediary medical billing.
• Knowledge of methods and terminology of financial and statistical clerical work, including general clerical auditing and verification techniques.
• Knowledge of general billing, medical terminology, billing forms, and the application of computerized accounting systems.
• Ability to lead staff and organize work to meet prescribed deadlines.
• Ability to understand and apply rules and regulations pertaining to medical billing policies and procedures.
• Ability to perform basic mathematical computations rapidly and accurately.

Qualifications

The most competitive candidate will have professional experience and knowledge with the following:

• Medical billing certificate.
• At least 3 years of medical billing and/or collections, specifically in a hospital setting.
• Experience with Epic software.
• Ability to review and interpret payor contracts.
• Knowledge of diverse payor mix: Medi-Cal, Medicare, Managed Care, Commercial, and other Government payors.
• Bilingual skills (preferred).

The ideal candidate will also be detail- and goal-oriented with strong verbal and written communication skills.

Schedule

9/80 schedule with every other Friday off: Monday – Thursday 7:30am – 4:30pm and working Friday from 7:30am - 3:30pm.

About the team

Founded in 1893, Riverside University Health System Medical Center has grown into a cornerstone of healthcare excellence and medical education in the region. Our highly skilled healthcare professionals and dedicated support staff are committed to delivering exceptional, state-of-the-art care to the diverse populations of Riverside County. Located in Moreno Valley, our 439-bed Medical Center is home to a Level I Trauma Center, a Level II Pediatric Trauma Center, and the county’s only Pediatric Intensive Care Unit (PICU).

For more information about RUHS Medical Center, please visit www.ruhealth.org.