Account Representative - USC Care MSO CBO - Full Time 8 Hour Days (Non-Exempt)(N

The Account Representative provides administrative support to the Consolidated Billing Office (CBO). Provide support, data entry, research and projects in assigned unit. Work as a member of the billing team to provide smooth operational flow resulting in optimum customer (internal and external) satisfaction and effective/efficient processes. Ensures that all related documents are accurately sorted and separated to ensure the appropriate billing needs and processes are addressed according to a complex set of guidelines for each client and/or payor. This position may be If Assigned to Payment Posting: Prepare and reconcile payment batches, input payment data, review reports for accuracy, makes corrections as necessary. The Account Representative will maintain consistent productivity standards as appropriate for their unit as well as maintain an average of 90% (score of 9.0) or better on Quality Reviews

Departmental Specific Summary


Essential Duties

• Collects and audits patient charge slips and reports. Obtains missing information, such as charge slips, patient demographics and insurance information.
• Assigns CPT-4 and ICD-9CM codes to medical services and diagnoses. Enters charge data into billing system. Verifies the accuracy of data entered. Mails insurance claims and patient statements. Prepares attachments, such as Explanation of Benefits copies, for secondary billing.
• Generates routine computer reports and/or printouts.
• Review and correct minor claim errors identified in front-end claim editor. Makes charge corrections as requested by coders and collectors.
• Maintains files on all documentation such as charge slips, Explanations of benefits, and client or patient information. Prepares and distributes reports.
• Verify insurance eligibility for assigned clinics. Registers patients into data system as necessary. Assists the department with insurance related projects for revenue collections.
• Reviews missing charges as identified in data system. Contacts department or providers to obtain missing information to clear missing charge.
• Reviews Explanations of Benefits from third party payors to determine if payment was made correctly and if denials can be re-billed. Obtains missing information, such as charge slips, patient demographics and insurance information.
• Prepares and reconciles payment batches accurately. Corrects errors or problems. Inputs data into billing system. Monitors reports for accuracy. Processes all forms of payments, including cash, checks and credit cards. Enters payment data into billing system and adjusts financial class to process balance of invoice.
• Provides assistance and guidance to the billing staff in resolving payment-related issues. Notifies supervisor of ongoing problems
• Prepares deposits. Maintains files on all documentation such as charge slips, Explanations of benefits, and client or patient information. Prepares and distributes batch report.
• Performs other related duties as assigned or requested.

Required Qualifications:

• Req High school or equivalent
• Req 2 years 2 to 3 years' experience in medical billing, coding, charge entry.
• Req Working knowledge of CPT & ICD-9 and ICD-10.
• Req Experience with Computerized billing systems, Computer Peripheral Equipment, Fax, Personal Computer, Photocopier, and Scanning, and laws governing charging and collection efforts.
• Req Knowledge of compliance, cost reimbursement, and insurance negotiating procedures.
• Req Ability to maintain confidentiality of sensitive information. Ability to recognize, evaluate, solve problems, and correct errors.
• Req Ability to deal courteously with patients and the public.
• Req Skill in establishing and maintaining effective working relationships with medical/office staff, insurance, organizations and the public.
• Req Excellent verbal and written communication skills.
• Req Ability to multi-task in a fast paces environment, prioritize projects and work independently with attention to detail.
• Req Demonstrate a high level of professionalism, customer service and interpersonal skills and operate under strict confidentiality.

Preferred Qualifications:

• Pref Working knowledge of Medicare, Medi-Cal/Caid, HMO, PPO, Commercial and Private Pay preferred.

Required Licenses/Certifications:

• Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)