Position Summary:

This position will provide day-to-day support as a Medical Group Accounts Receivable Specialist. This position focuses almost entirely on accounts receivable follow-up and is responsible for performing third party insurance follow-up in the Central Billing Office. The personnel within this position are responsible for accomplishing assignments in accord with established policy, procedure and production standards. This position must be equally capable of working independently as well as part of a team effort.

Essential Duties and Responsibilities include the following:

• Perform Insurance Follow-up with Accuracy
• This position performs insurance follow up of outstanding accounts receivable for all payers in the NextGen application, meeting the quality assurance standard at a rate of 96%. Quality measures will be rated by the following criteria: all outstanding invoices are processed, all actions taken are documented via NextGen work log and encounter comments with a high degree of specificity, appropriate actions taken (i.e. update registration, obtain records, contact clinical practice) ticklers are set and receive timely updates.
• Position works on outstanding accounts and documents work in NextGen or as assigned
• This is done via the processing of work file in “next” item order in the work file assigned or processing specific denials. This position must be thorough when researching denials and seeking documentation to appeal denied charges to third party and must follow the standards that have been set for processing accounts at a minimum of 50 accounts per day in the PCS system. Management has the right to alter these performance criteria as necessary, with advance notice.
• Proactively identifies trends and offers solutions
• Personnel Proactively identifies trends and offers solutions to recurring denials or payer nonpayment. This is done by recognizing the problem, providing assistance to quantify the problem, researching and offering solutions (i.e. claim form change, dictionary change, process change).
• Participates in any required accuracy audit and review process
• Works in concert with other CBO employees as assigned by the Director.

• Participates in educational activities
• Maintains strictest confidentiality and is knowledge and conforms to all HIPAA requirements and company HIPAA policies.

• Performs other duties as directed by management

The pay range for this position at commencement of employment is expected to be between $20 - $22 per hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.

The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.

Details of participation in these benefit plans will be provided if an employee receives an offer of employment.

If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.

As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.

Full Time Position Benefits:

The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.

Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.

Health and Wellness:

• Employer-paid comprehensive medical, pharmacy, and dental for employees
• Vision insurance
• Zero co-payments for employed physician office visits
• Flexible Spending Account (FSA)
• Employer-Paid Life Insurance
• Employee Assistance Program (EAP)
• Behavioral Health Services

Savings and Retirement:

• 401k Retirement Savings Plan
• Income Protection Insurance

Other Benefits:

• Vacation Time
• Company celebrations
• Employee Assistance Program
• Employee Referral Bonus
• Tuition Reimbursement
• License Renewal CEU Cost Reimbursement Program
• Business-casual working environment
• Sick days
• Paid holidays
• Mileage

Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.

Education and / or Experience:

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability preferred or required. Must have an excellent understanding of collections and payment posting as well as familiarity with medical reimbursement. Previous working knowledge of billing NextGen platform highly preferred.
• 3 years of billing or collections experience required. Knowledge of insurance company operating procedures and practices. Knowledge of governmental legal and regulatory provisions related to collection activities. Previous working knowledge of billing NextGen platform highly preferred.