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Billing Representative I – Pharmacy

Advocate Health Care

This is a Full-time position in Anaheim, CA posted May 21, 2022.

Reconciles and posts payments.

Monitors simple to moderately complex assigned accounts, corrects billing errors, identifies delinquent payments and re-submits as necessary.

Conducts prompt collection of accounts receivable and resolution of problems that are delaying payment.

Posts payments and reviews assigned accounts for any internal or external problems that may cause a delay in payment.

Analyzes available information and decides course of action.

Contacts insurance companies or any other person, organization or department whose assistance is needed to obtain payment of pharmacy claim, until it is paid or rejected.

Responds to telephone or written inquiries from insurance companies, employers, state agencies and patients regarding insurance claims.

Process rejections by billing the patient; or resolving problems, and having the claim resubmitted for payment.

Applies contractual allowances where necessary.

Acts as a resource person for the pharmacies on all issues relating to the assigned insurance type: i.e., commercial, HMO or government agency.

Updates Manager and co-workers on all changes and new procedures.

Maintains a basic knowledge of any contracts relating to assigned insurances.

Notifies Manager and/or Lead of any contract issues that arise.

Evaluates aged claims for probability of payment and refers those unlikely to be paid to collection as necessary.

Required Functional Experience Typically requires 1 year of experience in medical billing in a health care setting.

Knowledge, Skills & Abilities Proficient knowledge base and understanding of department specific billing procedures.

Proficiency in accounting and computerized patient accounting systems required.

Knowledge of medical terminology.

Good communication, analytic, and organizational skills with the ability to clearly explain/ discuss issues on the telephone.

Licenses & Certifications None Required.

Degrees High School Graduate.

What We’d Like to See Ideally would like some background in billing and working with audits, pharmacy knowledge would be a plus.

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– Worker’s Compensation Sheboygan, WI Patient Accounts Rep I Sheboygan, WI Patient Service Rep-Sheboygan Sheboygan, WI Advocate Aurora Health is committed to diversity and inclusion every single day and in everything we do.

Diversity lives in the differences, great and small, that matter to us and make each of us unique
– from our age and the color of our skin, to our abilities and the things we believe in.

We know that empowering our differences inspires creativity that leads to innovative solutions
– for our team members, consumers and communities.

And because health care is built upon relationships, it’s important for the people we serve to be able to trust us to meet their unique needs.

By cultivating an atmosphere of acceptance and compassion, we create a welcoming environment where our patients can heal, our team members can thrive and our business can grow.

As a team member, working in a diverse setting allows you the chance to grow in ways that will broaden your perspective to deliver the best possible patient care.

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