Patient Account Rep, Commercial Biller - FT Days

Patient Account Representative Commercial Insurance Biller Non-Certified:

Under the supervision of the Billing Manager, this position is responsible for the timely and accurate billing of commercial and group insurance inpatient and outpatient accounts. This includes the pre-billing, billing and electronic submission of hospital claims; identification and processing of appropriate write-offs, accurate use of HMO matrix to identify responsible payer, identification of stop loss claims and “carve out” items that are reimbursed at different rates.  Ensures compliance to the payer’s contracted billing requirements.  Performs timely billing of commercial or group secondary insurance.  Coordinates with the Medicare and Medi-Cal team for any MSP issues, HMO acknowledgements or Medicare/Medi-Cal as secondary billing. Meet and exceed the minimum productivity volume, and standards of work as defined within the departmental policies and procedures.

PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Hospital - Whittier, PIH Health Hospital - Downey and PIH Health Good Samaritan Hospital, 27 outpatient medical locations, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, women’s health, urgent care and emergency services. The organization is recognized by Watson Health as one of the nation’s Top Hospitals, and College of Healthcare Information Management Executives (CHIME) as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. PIH Health is certified as a Great Place to Work ^TM. For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.

Required Skills

Patient Account Representative Commercial Insurance Biller Non-Certified:

• Demonstrated ability to use a 10-key adding machine, calculator, fax machine, photocopy machine keyboard for data entry and personal computer (PC). 
• Ability to perform multiple tasks, good mathematical skills, sound decision making abilities and good verbal and written communication skills.
• Ability to learn new systems, become proficient in development of reports via hospital systems and tools provided, proficient in excel and word document.

Required Experience

Patient Account Representative Commercial Insurance Biller Non-Certified:

• High school graduate preferred. 
• Two years college preferred. 
• Minimum two years in hospital commercial and group insurance billing and follow up required. 
• Knowledge of commercial or group insurance billing requirements and regulations.
• Evidence of continuing education preferred. 
• Understanding of CMS rules and regulations concerning of accurate claims submission.