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NorthBay Health · 3 months ago

Patient Account Representative III Professional Billing

Fairfield, CA

Full-time

Onsite

Mid Level

$31/hr - $37/hr

3+ years exp

NorthBay Health is an independent, nonprofit health system dedicated to providing exceptional care. The Patient Account Representative III is responsible for the timely and accurate billing, follow-up, and collection of ambulatory patient accounts, ensuring compliance with regulatory requirements and internal billing practices.

Health CareHospitalMedical

Responsibilities

Responsible for the timely and accurate billing, follow-up and collection of ambulatory patient accounts

Processing of accounts for all services and specialties offered within the NorthBay Ambulatory practices through the use of standard and NorthBay prescribed billing practices and regulatory requirements

Qualification

Professional fee billingCPT4 codingICD-10 codingMedicare proficiencyMedi-Cal proficiencyCommercial insurance proficiencyUB-04 billingHCFA 1500 billingMedical terminologyProblem solvingTeamworkEffective communicationAdaptability

Required

High school graduate or equivalent preferred

Three to five years of recent professional fee billing and collections experience, preferably in a multi-specialty practice environment required

Familiarity with use of CPT4, HCPCS and ICD-10 coding

Proficiency in Medicare, Medi-Cal and Commercial insurance plans, both HMO and PPO

Experience with UB-04 and/or HCFA 1500 claim forms billing

Experience in account follow up resolution for both electronic and manual claims

Demonstrated ability to effectively investigate, analyze and problem solve

Demonstrated service and success in teamwork and consistent high productivity and quality

Ability to quickly master computer programs related to claims processing

Ability to understand the terms of payor contracts and fee schedules

Ability to understand Knox-Keene regulations as well as demonstrate an understanding of managed care concepts and terminology

Ability to effectively prioritize work, as well as the ability to process accounts quickly to meet deadlines

Ability to process claims accurately and timely

Ability to exercise appropriate, independent judgment and effectively solve problems

Knowledge of medical terminology

Ability to perform several different types of tasks each day and to adapt to changing priorities

Knowledge of personal computers with an emphasis on public folders, shared drives, Internet, and downloading and sorting spreadsheets and word processing programs required

Ability to communicate effectively and pleasantly to members, providers, payors and internal staff is essential

A willingness to work as a team player with co-workers and other internal staff, as well as people outside NorthBay

Consistent attendance and work at the agreed upon hours of work is required