JOB SUMMARY:

Under the direction of the Manager Professional Billing & Coding, the Billing & Collections Representative II (BCII) is responsible for the resolution of all outstanding balances from all payors, including but not limited to; Commercial, Medi-Cal and Managed Care professional claims. This position is responsible checking status of unpaid claims by telephone, websites and/or any other means available in an efficient and timely manner. BCII is expected to provide all necessary documentation required from payors to ensure accurate adjudication of claim for reimbursement. They will process claims correctly following contractual arrangements the Medical Practice Foundation (MPF) has with each Payor. This incumbent is expected to accurately analyze each denial received by reviewing the patient acct, the remittance codes from Explanation of Benefits (EOB) and Remittance Advice (RA). As well, they are to review CCI or payor specific coding edits and take necessary steps t...