The Insurance Follow-Up Representative (Medi-Cal) will be responsible for all collection functions for hospitaland physician services. This primary responsibility of this position is account resolution which includes the following duties: reviewing accounts, following up with Medi-Cal and various insurance companies on claim status, gathering and submitting any missing information, rebilling, appeals, and billing out secondary electronic or paper claims to all payers as needed.

Duties/Responsibilities

• Provide customer service to various healthcare contract customers
• Prepare, research and collect from Medi-Cal and various contracted health insurance payers
• Research remits and Explanation of Benefits (EOBs) for complete accurate payments or denials
• Provide or arrange for additional information when needed
• Submit corrected claims or appeals
• Request appropriate adjustments, when required
• Identify items that require client assistance
• Gather payor trends and provide feedback
• Other duties as assigned

Required Skills/Knowledge

• Medi-Cal experience required
• EPIC experience preferred
• Microsoft Office
• Knowledge in government and non-government billing guidelines for facility/physician
• Knowledge in account/claim status, resolution, and appeals process
• Knowledge of the UB04 and HCFA forms
• Excellent customer service and time management skills
• High attention to detail required
• Excellent verbal, written, and electronic communication skills required

Education/Experience

• High school diploma or General Education Development (GED) certificate required
• One to Two years of college preferred
• Minimum of three years of experience preferred
• Prior medical billing and insurance collections or healthcare revenue cycle experience preferred