Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Saint Mary's Medical Group is affiliated with Saint Mary’s Regional Medical Center, one of the nation’s “100 Top Hospitals” and “A” rated for patient safety. We offer incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.
The Biller is responsible for submitting claims to the appropriate intermediaries and to ensure that procedures and charges are coded in compliance with all payers including Medi-Cal and/or Medicare regulations. Responsible for obtaining required authorizations necessary for the processing and payment of claims. The Biller is responsible for the follow-up and denial management as necessary for final resolution. Responsible to identify the various types of diagnosis and procedures codes (ICD9, CPT, HCPCS, DRG) as they relate to reimbursement. Communicates clearly and efficiently by phone and in person with clients and staff members. Maintains productivity standards and reports. Obtains updated demographic information and all necessary information needed to comply with the various Government Programs billing requirements. Operates computer to input follow up notes and retrieve collection and patient information. Maintains proficiency in Medical Terminology
EDUCATION, EXPERIENCE, TRAINING
1. Previous Billing Experience within a hospital Business Office Required.2. Previous experience with government programs and collections preferred.3. Knowledge of medical terminology4. Effective written and verbal communication skills5. Ability to multi-task, prioritize needs to meet required timelines6. Analytical and problem-solving skills7. Customer Services experience required8. High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)
Full Time
Days
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
About Prime Healthcare and Prime Healthcare Foundation: Prime Healthcare is an award-winning health system operating 51 hospitals and more than 360 outpatient locations in 14 states, providing over 2.5 million patient visits annually. It is one of the nation's leading health systems, with nearly 57,000 employees and affiliated physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Based in Ontario, California, Prime Healthcare is nationally recognized for award-winning quality care and has been named a 10 Top and 15 Top Health System by Truven Health Analytics. Its hospitals have been named among the nation's "100 Top Hospitals" 69 times and have received more Patient Safety Excellence Awards from Healthgrades than any other health system in the past eight years. To learn more, please visit primehealthcare.com.
