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HBC Specialist Job Details

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Job ID Number:  2716907
Job Type:  Full Time
States:  California (CA)
City:  Milpitas
Job Description: 

Spectra Laboratories, Inc is looking for ( 2) temporary Healthcare Billing Collections Specialists. The assignment is for approximately 3 months with a possibility of being extended.

For nearly 30 years, we've learned the importance of working side-by-side with our customers to support their unique needs, processes and schedules.

And as the leading provider of renal-specific testing services, performing more than 58 million tests each year, we understand the unique needs of dialysis patients and those who care for them.

Every day we deliver comprehensive testing, analysis and reporting with the reliability and personal service you require to ensure the best outcomes possible for your patients.

It's all made possible by our unmatched infrastructure that includes dedicated renal professionals, state-of-the-art analytical equipment, automated specimen processing and advanced reporting applications.

A wholly-owned subsidiary of Fresenius Medical Care , the world's largest vertically integrated dialysis service provider, Spectra is committed to constant innovation and quality service. We look forward to working with you to support all your renal testing needs.



Description

DUTIES / ACTIVITIES :

Obtains and verifies insurance coverage and eligibility, works billing exception reports, resolves credit balances on patient account and contacts insurance payers to collect payment on denied or rejected claims.



PRINCIPAL RESPONSIBILITIES AND DUTIES :

The following duties and responsibilities reflect the expectations of this position but are not intended to be all inclusive.

1. Maintain confidentiality of patient, employee and company information in accordance with HIPAA regulations and Spectra Laboratories policies.

2. Must be able to perform all job functions of a Billing Rep III and AR Rep III.

3. Work non-reimbursable reports to obtain medically justified ICD9 codes daily to ensure accurate and timely billings in all applicable applications. Accessions should be limited to the current month.

4. Take appropriate steps according to company policies to resolve credit balances, including but not limited to requesting a refund or recoupment and posting the appropriate transaction in all billing systems.

5. Develop and maintain a positive working relationship with clinic personnel, teammates and payer representatives.

6. Respond to incoming correspondences and telephone calls.

7. Intermediate knowledge of the payment, denial and refund processes.

8. Review and respond to refund request letters.

9. Prepare and process appeals based on individual payer guidelines.

10. Enter corrected information and transfer invoice via TRM or manually resubmit claim as needed.

11. Intermediate knowledge of ESRD and payer billing rules, coordination of benefits and denial codes,

12. Obtain indigent patient status and waiver forms.

13. Troubleshoot and resolve billing related issues and complex claim and cash remittance issues for appropriateness and resolution.

14. Investigate duplicate payments and take appropriate action to resolve.

15. Provide feedback regarding workload, policies, training, etc.

16. Work various reports, including but not limited to, exception and error reports.

17. Resolve missing and or invalid ICD9 codes on denied claims or unbilled logs.

18. Assist colleagues and clients with ICD9 code related issues.

19. Track refund, recoupment and adjustment requests.

20. Perform all other related duties and special projects as assigned.



Requirements
EXPERIENCE AND REQUIRED SKILLS :

· Must have a minimum of three years of demonstrated experience in business and accounting practices, preferably in a healthcare setting.

· Must have excellent phone etiquette and verbal and written communication skills.

· Must be able to multi-task, prioritize and manage time effectively.

· Must be able to work in a team structure as well as independently.

· Basic computer skills and proficiency, including but not limited to Word and Excel is required.

RELATIONSHIPS :

Internal Contacts:

Various departments of Spectra Laboratories

External Contacts:

Various external vendors, clients and third party payers (includes Medicare, Medi-Cal, etc.)

FMS staff (corporate and billing groups).

PHYSICAL DEMANDS AND WORKING CONDITIONS :

The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Employees must be able to lift 20 pounds and sit and type for extended periods of time.



Spectra Laboratories, Inc. is an Equal Opportunity Employer
Employer:  Fresenius Medical Care
11/02/2011
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