Patient Account Rep - Prof Billing - FT - Days - Billing and Collection @ MV

El Camino Health; Mountain View (CA); On-site; USD 48,000 - 73,000; Full time

Job summary

El Camino Health is seeking a Billing Clerk to join our Mountain View team. You will handle claims billing, respond to inquiries, process payments, and follow up on denials to ensure timely reimbursement.

The role requires accurate data entry, strong communication, and the ability to multi-task in a fast-paced hospital setting. Join us to support high-quality patient care through precise financial operations.

Qualifications

• High School Diploma or equivalent.
• One year related work experience in a Hospital, Physician, or other healthcare setting.
• Strong verbal and written communication skills.
• Works in a collaborative and team manner.
• Efficient organizational skills and effective reasoning, problem solving and critical thinking skills.
• Excellent typing skills.
• Ability to multi-task and demonstrate effective time management.
• Preferred knowledge and use of Microsoft Products: Outlook, Word & Excel.
• Strong attention to detail.
• Ability to process a high volume of work.

Responsibilities

• Ensures claims are billed timely and accurately using the Hospital Claims Scrubber Tool and billing system.
• Resolves claim edits.
• Collaborates with departments to resolve applicable claim errors.
• Reports all unbilled claim information and issues that may delay billing to Management to ensure there is no adverse effect on Hospital Cash Collections or Accounts Receivable.
• Receives and processes correspondence and phone or online inquiries from patients, payers or any other third party in a timely and professional manner.
• Resolves patient billing inquiries and processes patient payments over the phone or in person.
• Follows up on unpaid and denied claims for account resolution.
• Resolves accounts by contacting managed care entities, other third party payer organizations or patients to facilitate timely payments.
• Performs research and makes determination of appropriate actions for payment resolution.
• Writes and submits appeals for denied claims.
• Keeps informed of managed care and contractual arrangements to resolve accounts by managed care payers.
• Assigns root causes to denials based on research.
• Posts daily cash and adjustments for Hospital and Professional billing.
• Resolves undistributed payments and performs cash reconciliation.
• Reports all payment issues to Management to ensure there is no adverse effect on Hospital Cash Collections or Accounts Receivable.
• Resolves credit balances that are due to patients.
• Audits and reconciles accounts to confirm credit balance and submits refunds in a timely manner.

Skills

Strong verbal and written comm.,

Efficient organizational skills

Time management

Multi-tasking

Teamwork

Typing skills

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

El Camino Health is committed to hiring, retaining and growing the best and brightest professionals who will carry our mission and vision forward. We are proud of our reputation in the community: One built on compassion, innovation, collaboration and delivering high-quality care. Come join the team that makes this happen.

FTE 1 Scheduled Bi-Weekly Hours 80 Work Shift Day: 8 hours

Job Description

Unit Specific Duties Listed Below

Billing

• Ensures claims are billed timely and accurately using the Hospital Claims Scrubber Tool and billing system.


• Resolves claim edits.


• Collaborates with departments to resolve applicable claim errors.


• Reports all unbilled claim information and issues that may delay billing to Management to ensure there is no adverse effect on Hospital Cash Collections or Accounts Receivable.

Customer Service

• Receives and processes correspondence and phone or online inquiries from patients, payers or any other third party in a timely and professional manner.


• Resolves patient billing inquiries and processes patient payments over the phone or in person.

Follow Up

• Follows up on unpaid and denied claims for account resolution.


• Resolves accounts by contacting managed care entities, other third party payer organizations or patients to facilitate timely payments.


• Performs research and makes determination of appropriate actions for payment resolution.


• Writes and submits appeals for denied claims.


• Keeps informed of managed care and contractual arrangements to resolve accounts by managed care payers.


• Assigns root causes to denials based on research.

Payment Posting

• Posts daily cash and adjustments for Hospital and Professional billing.


• Resolves undistributed payments and performs cash reconciliation.


• Reports all payment issues to Management to ensure there is no adverse effect on Hospital Cash Collections or Accounts Receivable.

Self Pay Credit Balances

• Resolves credit balances that are due to patients.


• Audits and reconciles accounts to confirm credit balance and submits refunds in a timely manner.

Qualifications

• High School Diploma or equivalent.


• One year related work experience in a Hospital, Physician, or other healthcare setting.


• Strong verbal and written communication skills.


• Works in a collaborative and team manner.


• Efficient organizational skills and effective reasoning, problem solving and critical thinking skills.


• Excellent typing skills.


• Ability to multi-task and demonstrate effective time management.


• Preferred knowledge and use of Microsoft Products: Outlook, Word & Excel.


• Strong attention to detail.


• Ability to process a high volume of work.

Unit Specific Qualifications

• Billing
  
  
  
  • Knowledge of medical terminology and billing.
  
  
  • Prior experience with facility billing or a similar role.
  
  
  • Understands Medicare, Medi-Cal, HMO, PPO and 3rd party rules and regulations.
  
  
  
  


• Customer Service
  
  
  
  • Prior experience in a customer service setting.
  
  
  • Preferred knowledge of health insurance coverages.
  
  
  
  


• Follow Up
  
  
  
  • Experience with claim processing and denial follow up and resolution.
  
  
  • Knowledge of insurance appeal writing.
  
  
  • Basic knowledge of contracting.
  
  
  • Understands Medicare, Medi-Cal, HMO, PPO and 3rd party rules and regulations.
  
  
  
  


• Payment Posting
  
  
  
  • Preferred cash and adjustment posting background with regards to quality control of payments and transactions to financial system.
  
  
  • 10-key preferred.
  
  
  
  


• Self Pay Credit Balances
  
  
  
  • 10-key preferred.
  
  
  • Knowledge of basic accounting practices and procedures.
  
  
  
  

License/Certification/Registration Requirements

None required

Ages of Patients Served

This position will serve all age groups.

Salary Range

$35.10 - $52.66 USD Hour

Physical Requirements and Working Conditions

The Physical Requirements and Working Conditions of this job are available. Sedentary Work - Duties performed mostly while sitting; walking and standing at times. Occasionally lift or carry up to 10 lbs. Uses hands and fingers. - (Physical Requirements-United States of America)

Equal Opportunity Employer

We welcome applications from all backgrounds. El Camino Health seeks and values a diverse workforce. The organization is an equal opportunity employer and makes employment decisions on the basis of qualifications and competencies. El Camino Health prohibits discrimination in employment based on race, ancestry, national origin, color, sex, sexual orientation, gender identity, religion, disability, marital status, age, medical condition or any other status protected by law. In addition to state and federal law, El Camino Health also follows all applicable fair and equitable employment policies from the County of Santa Clara.

About Us

At El Camino Health, our nationally recognized doctors and care teams are committed to providing you with high-quality, excellent care. We aim to deliver a healthcare experience that is designed around your individual needs. When you choose El Camino Health for your care, you can count on:

Distinguished hospitals. Our fully accredited hospitals, Los Gatos, and Mountain View, have received numerous awards and honors for high-quality healthcare. Exceptional talent. Our reputation attracts high-calibrated doctors who are approachable and friendly, a nursing culture exceptional for its highly personalized patient and family care, and leadership with a deeply personal commitment. Innovative approaches to care. We seek new treatments and techniques, and contribute to the medical community through clinical trials. Our urgent care sites powered by Carbon Health enable easy, immediate scheduling and follow up through the Carbon Health app.

A focus on health. Our regional Men's Health Program offers a team approach to care and has a variety of specialists who are focused on men’s health issues, including heart and vascular, urology, sleep disorders, sexual dysfunction and healthy weight. We created the South Asian Heart Center and the Chinese Health Initiative to address unique health disparities in our patient population. A healing environment. Our spaces were specially designed for tranquility and comfort.