Education and Work Experience:

• High School Education/GED or equivalent: Preferred
• Associate's/Technical Degree or equivalent combination of education/related experience: Preferred
• Medical billing and collections experience: Preferred

Essential Functions:

• Ensures all required forms, ID, insurance cards, etc. are obtained, completed, signed, and forwarded to the appropriate individuals/departments.
• Reviews status of unpaid accounts and resubmits claims or responds to payment delay. Submits Claim Inquiry Forms (CIF) when appropriate. Monitors reports of unbilled, unpaid and denied accounts. Utilizes appropriate system to prioritize account follow-up and denial reason code entry.
• Process Medicare and Medical billable claims (UB and 1500). Document reasons for unbillable accounts and forward to manager/ government supervisor for intervention and assistance. Responds to intermediary claim development requests (ADRs) and (RTDs) documents and submits within the timeframes provided by the requestor.
• Documents RCI using appropriate action item for quality control and training opportunities. Submits all non-covered write offs prior to billing. Ensures compliance issues are audited and resolved prior to billing. Manages accounts until balance is paid, becomes patient portion and resolve any credit balances.
• Generates letters. Enters and sorts data.
• Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.