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Lead, Revenue Cycle Representative


This is a Full-time position in Anaheim, CA posted February 23, 2021.

Title: Lead, Revenue Cycle Representativen n Wage Category: Hourly, Non-Exemptn n Reports to: Supervisor, Revenue Cyclen n Salary Range: Commensurate with experiencen n Job Summaryn n The Insurance-Revenue Cycle Lead provides day-to-day assistance and technical support to assigned team.

Partners with management to standardize, develop and update workflow processes, and monitor team productivity and quality, while working Accounts receivable to maximize reimbursement.

n n Essential Job Functionsn n An effective Revenue Cycle Lead will exemplify the MediRevv Mindset by helping the organization on a whole achieve balance between partners, people, and performance.n Utilizes knowledge of PPO, HMO, Government, and DME billing guidelines.

Works higher dollar threshold invoices as deemed necessary by management.

Maintains daily billing and collector productivity reports, including detail of accounts and reasons for unbilled claims.

Reviews all problem claims to determine reasons for, and possible resolutions of, problems and delegates follow-up back to the collector for action.

Train and mentor all new employees on policies, procedures and systems.

Works with management to standardize work flows and establish/improve processes to promote efficiency and productivity Ensures all paper claims are reviewed and mailed for Medi-Cal, PPO, EPO, Behavioral Health, Insured Services, Worker”s compensation and secondary insurance claims on a daily basis.

Ensures all edits are worked daily, identifying and notifying manager of trends in errors so that procedure notices and/or additional training to front-end staff can occur.

Correct clearinghouse rejections and payer rejections daily.

Notify manager regarding payer rejection trends.

Ensures all incorrect charge and claim discrepancies are corrected.

Ensure incoming payer correspondence is resolved within 48 hours of receipt.

Ensures pre-certifications and TARS are obtained as required by policy and in a timely manner.

Ensures Medicare and Medi-Cal provider numbers are obtained in a timely manner and that required provider re-credentialing information and additional credentialing information is sent to these payers as requested.

Researches and monitors provider updates in GE/IDX.

Ensures FFS patients” insurance information including co-payments and deductibles on new and existing patient accounts is obtained, verified and updated in GE/IDX on the IMS screen.

Responsible for ensuring the accurate recording of the insurance information in GE/IDX.

Updates supervisor on team and individual work accomplishments, issues, progress and training needs.

n n Qualificationsn Education: High School graduate or equivalent Experience: Requires three (3) years of medical billing and/or collections experience preferably as a Sr.

level representative Computer Skills: IDX experience and Microsoft Office knowledge highly desirable.EPIC experience preferred n Knowledge / Skills / Abilities: A successful candidate must have proficient knowledge/capabilities in the following areas:n Advanced knowledge of third-party billing requirements including: PPO, EPO, HMO, Indemnity, Medicare, MediCal, Work Comp.

Demonstrate knowledge with medical terminology, coding (CPT/ICD10/HCPCS) and standard electronic billing format.

Understands billing timeliness and urgency in meeting all claims and filing deadlines.

Keeps current with knowledge of professional payer contracting agreements.

Excellent customer service and communication skills Advanced knowledge of computerized registration, billing and collections procedures Excellent problem resolution experience and client advocacy skills.

Must have a professional and mature demeanor.

Must be able to work in a fast-paced department and handle multiple tasks, work with interruptions and deal effectively with confidential information.

Ability to make judgment call with confidence, problem solve, delegate and disperse workload according to individual strengths Bilingual (English/Spanish) a plus n n Physical Requirementsn n The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.n While performing the duties of this job, the employee is regularly required to, stand, sit; talk, hear, and use hands and fingers to operate a computer and telephone keyboard reach, stoop kneel to install computer equipment Specific vision abilities required by this job include close vision requirements due to computer work Light to moderate lifting is required Regular, predictable attendance is required; including increased hours as business demands dictate.

n n The Real Deal n n When you become a MediRevver great things happen.

You can expect training, support, and a work family like no other.

In return, we expect honesty, integrity, and the celebration of our differences.

It”s that simple.

nnby Jobblenn