Temporary Senior Insurance Billing Clerk - Patient Accounting-Billing

Ruhealth; Riverside (CA); Presencial; USD 45.000 - 65.000; Jornada completa

Descripción de la vacante

Riverside University Health System Medical Center in Riverside, CA seeks a Senior Insurance Billing Clerk to join the Patient Accounting-Billing team. The role involves handling denied claims, complex account resolution, staff training, and advising payors and patients on billing matters.

The ideal candidate has 5+ years hospital billing experience, a medical billing certificate, proficiency with Epic, and bilingual abilities to navigate diverse payor contracts and regulatory requirements.

Formación

• Must have a medical billing certificate.
• At least 5 years of medical billing and/or collections in a hospital setting.
• Experience with Epic software.
• Ability to review and interpret payor contracts.
• Knowledge of Medi-Cal, Medicare, Managed Care, Commercial and other government payors.
• Bilingual in English and another language.

Responsabilidades

• Lead and train staff on billing processes.
• Review and follow up on denied claims and perform complex account resolution.
• Draft appeal letters and communicate with payors; handle notices and disputes.
• Verify patient insurance information and eligibility; assist patients and internal departments.
• Ensure accuracy of bills and preparation of ATPs for data entry; monitor accounts for payment.

Conocimientos

Bilingual

Denial management

Follow-up on claims

Educación

Medical billing certificate

Herramientas

Epic

Descripción del empleo

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/or 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.

For questions regarding this recruitment: Contact Ahjah Davis - Solomon at [e-mail] or 951-955-9233. Please allow 1-2 business days for response to general inquires.