Posted 23 days ago
Commercial Insurance Specialist
RiversideOn-site
AI Summary
Performs clerical billing and follow-up functions for commercial insurance, ensuring claims are processed correctly and in compliance with hospital and federal policies.
About this role
Overview
Performs various clerical billing and follow up functions, but not limited to items listed in the Performance Criteria.
Responsibilities
Comply with hospital and federal policies and guidelines in the billing and collection of claims. Reviews payor contracts to ensure correct contractual adjustments are posted as per individual payor agreement.
Qualifications
High school diploma or equivalent. CPT-4, HCPCs, DRG, ICD-9 coding knowledge. Minimum 2 years Medicare MediCal billing and follow up experience in a hospital setting.
Skills
Claims Follow-upContractual AdjustmentsCPT-4DRGHCPCSHospital BillingICD-9Medical BillingMedicare BillingPayor Contract Review
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