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Authorization/Billing Representative 562057

Healthcare/Medical | Emeryville, CA | Full Time and Contract

Job Description

Authorization/Billing Representative

Under the direction of the Revenue Manager and/or supervisor, the biller/auth rep will work independently to resolve billing related issues in APeX (Epic) in order to help maximize payer reimbursement and RVU charge capture.  He/she must have basic understanding of healthcare terminology, processes and work flow and healthcare billing/authorizations in order to make good decisions and resolve account issues.  The incumbent should also have outstanding people skills, including telephone technique, professional appearance, organizational skills, and communication skills (oral and written).

Responsibilities:

  • Manages the Authorization/billing work queues {WQ} in APeX on a daily basis, keeping Authorizations and edits at a minimum by working requests and deficiencies in WQ  (The WQ areas include but are not limited to Account, Router WQ, Charge Review WQ, RFI WQs, and Patient WQs)
  • Works and communicates effectively with coworkers and external coders to resolve any billing/charge capture related issues
  • Provides requested documentation such as operative reports, doctor’s notes, and insurance info to aid in the reimbursement process
  • Obtains required authorizations of procedures while maintaining current list on those insurances (this includes pre-service, post service retro/modifications and appeals if needed)
  • Contacts insurance companies directly on accounts that may need additional follow up for claim resolution

Requirements:

  • High school diploma or equivalent
  • Previous billing experience in a large academic hospital
  • CPC certified – newly certified is fine

Preferred:

  • Bachelor’s degree and/or experience working with HMO, Commercial, Medicare, Medi-Cal and Workers compensation insurance in the healthcare billing/authorization environment
  • Epic experience
  • Hospital Billing experience (min. 1 year)
  • Doctors Office, Ambulatory billing experience ( min. 3-4 years)

Possible temp to hire position for the right candidate

$20-$25 Per Hour                   Emeryville, CA  94608           4 Month Assignment