Temporary Senior Insurance Billing Clerk - Patient Accounting-Billing

Ruhealth; Riverside (CA); On-site; USD 60,000 - 78,000; Full time

Job summary

Riverside University Health System Medical Center in Riverside seeks a Senior Insurance Billing Clerk to join the Patient Accounting-Billing team. The role focuses on reviewing denied claims, complex account resolution, and training staff, while drafting dispute letters and appeals to payors for hospital billing and special programs.

The ideal candidate will have a medical billing certificate, 5+ years in hospital billing/collections, knowledge of payor contracts, and be bilingual.

Qualifications

• Two years experience performing fiscal, statistical and fiscal record keeping with at least one year in third party medical billing.
• Knowledge of payor contracts and diverse payor mix including Medi-Cal, Medicare, Managed Care and government payors.
• Ability to lead staff and communicate effectively in writing and verbally.

Responsibilities

• Leads and trains staff; serves as a resource for solving procedures and regulations.
• Checks and corrects bills for numerical accuracy and prepares data for entry.
• Reviews patient accounts to ensure accuracy and makes adjustments as needed.
• Registers patients for emergency and non-emergency services.
• Verifies billing forms for completeness and accuracy against records.

Skills

Medical billing certificate

5+ years hospital billing/collections

Payor contracts review

Bilingual

Tools

Epic

Job description

The County of Riverside - Riverside University Health System (RUHS) - Medical Center is seeking a Senior Insurance Billing Clerk to join their Patient Accounting-Billing team in Riverside.

Under general supervision, the incumbent will be responsible for reviewing and making follow-up determinations on denied claims while performing complex account resolution, leading and training staff, serving as a trusted resource in navigating challenging problems related to procedures, regulations, and complex accounts, drafting original correspondence, dispute letters, and appeals to payors—specifically for facility (hospital) billing and special programs—and providing exceptional customer service support to both internal and external clients, interpreting and explaining regulations, contractual language, and legal obligations, monitoring accounts for payment, and recommending solutions for delinquent accounts, reviewing patient insurance forms for accuracy, contacting patients and insurance companies to obtain treatment authorizations and verify eligibility, responding to requests for account information, and initiating calls to patients, insurers, and internal or external departments regarding billing and follow-up matters; leading and performing specialized and more difficult fiscal clerical work in connection with processing and billing fiscal intermediaries for medical services rendered to patients; and to do other work as required.

The most competitive candidate will have professional experience and knowledge with/of the following:

• Possess a medical billing certificate
• At least 5 years of medical billing and/or collections, specifically in a hospital setting
• Epic
• Ability to review and interpret payor contracts
• Knowledge of diverse payor mix - Medi-Cal, Medicare, Managed Care, Commercial and other Government payors
• Bilingual

The ideal candidate will also be detail and goal oriented and have good verbal and written communication skills.

Work schedule:

9/80 schedule with every other Friday off: Monday – Thursday 7:00am – 4:30pm and working Friday from 7:00am -3:30pm

Meet the Team!
Founded in 1893, Riverside University Health System Medical Center has grown into a cornerstone of healthcare excellence and medical education in the region. Our highly skilled healthcare professionals and dedicated support staff are committed to delivering exceptional, state-of-the-art care to the diverse populations of Riverside County.

Located in Moreno Valley, our 439-bed Medical Center is home to a Level I Trauma Center, a Level II Pediatric Trauma Center, and the county’s only Pediatric Intensive Care Unit (PICU). If you’re passionate about making a meaningful difference and helping others, RUHS Medical Center is the place for you!

For more information about RUHS Medical Center, please visit www.ruhealth.org

• Leads and trains staff; Serves as a resource for staff in the solution of difficult problems relating to procedures and regulations; Assists staff in resolving a variety of difficult problems.
• Checks and corrects bills and accounts for numerical accuracy, proper coding and prepares ATP's for data entry.
• Reviews patient accounts to determine the accuracy of account information and makes any required adjustments for proper billing purposes.
• Registers patients for medical services such as emergency treatment care and non-emergency walk-in treatment.
• Verifies billing account or insurance forms for completeness and accuracy against a variety of automated and manual records.

Experience:

Two years experience performing fiscal, statistical and fiscal record keeping functions with at least one year involving third party intermediary medical billing.

Knowledge of:

Methods and terminology of financial and statistical clerical work including knowledge of general clerical auditing and verification techniques; General billing, medical terminology, and billing forms with knowledge of the application of computerized accounting systems.

Ability to:

Lead staff; Understand and apply rules and regulations pertaining to medical billing policies and procedures while identifying routine billing errors and differentiate between appropriate applications of various billing methods; Perform basic mathematical computations rapidly and accurately; Organize work to meet prescribed deadlines.