SNF Managed Med-Cal Billler - Eureka

Rockport Healthcare Services; Eureka (CA); Vor Ort; USD 52.000 - 76.000; Vollzeit

Zusammenfassung

Rockport Healthcare Services in Eureka, CA seeks a claims billing specialist to manage Medi-Cal billing for SNF services. The role involves submitting claims to third parties, ensuring proper information and timely filing to support cash flow.

You will follow up on claims to confirm receipt and maintain verification logs, coordinate authorizations, and validate documentation before submission. Additionally, you will review aging, identify unpaid accounts, and complete follow-up monthly to reduce

Qualifikationen

• 5 years of Medi-Cal billing experience in a SNF environment.

Aufgaben

• Submits reimbursement claims to third parties for services at assigned facilities.
• Ensures claims contain required information and format; reviews for errors before submission.
• Submits claims within required timeframes to maintain cash flow and reduce denials.
• Follows up on claims to confirm receipt by payer and maintains verification logs.

Kenntnisse

Medi-Cal billing

Claims submission

Jobbeschreibung

Essential Job Functions:

1. Submits reimbursement claims to third parties (insurance health plans, government agencies, etc.) for services rendered at assigned facilities.
2. Ensures claims have the required information in the specified format. Reviews claims for errors prior to submission.
3. Submits claims within the required timeframes to ensure consistent cash flow and reduce risk of technical denials for untimely filing.
4. Follows up on claims to ensure third party or government agency received the claim:
   • a. Electronic billing verification no less than 48-hours after claim submission
   • b. Hard copy billing no less than 14 days after claim mailed
5. Coordinates receipt of insurance authorization with facility and maintains missing authorization log no less than weekly.
6. Validates supporting documentation prior to submitting the claim including but not limited to balanced census, triple check, authorization, etc.
7. Reviews aging no less than monthly and identifies unpaid accounts. Completes follow-up on all unpaid accounts monthly.

Qualifications:

5 Years Managed Medi-Cal Billing Experience in a SNF environment