We’re a nonprofit, regional healthcare network with two hospitals, numerous outpatient medical offices, a multi-specialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer and emergency services. Our leadership is dedicated to putting patients first—a cornerstone of our mission, vision and values—as we deliver top-quality healthcare.
From our extensive facilities in Whittier, California and Downey, California, PIH Health serves more than two million residents in Los Angeles and Orange Counties and throughout the San Gabriel Valley.
Under the supervision of the Insurance Billing Manager, the Patient Account Representative, Commercial Insurance Follow Upis responsible for the timely and accurate follow up of Commercial and Government HMO insurance Accounts Receivable. This consists of contacting the appropriate responsible payer for the status of submitted claim(s) and resolution of delays in payment or underpayments of the contracted amount due to PIH Health for its services rendered. Responsible for interpreting contracts to calculate expected reimbursement, identifying additionally reimbursed contract carve outs, and submitting appropriate contractual adjustments and write-offs.
- Demonstrated ability to utilize personal computer, 10-key adding machine, calculator, fax machine, copier and scanners.
- Able to multi-task.
- Good mathematical skills
- Excellent verbal and written communication skills
- Sound decision making.
- High school graduate preferred; two years college preferred.
- Must have a minimum two (2) years of experience in hospital Commercial Follow up and/or Billing is required.
- Knowledge of Insurance and Government Billing guidelines and regulations.
- Understanding of Medicare CMS rules and regulations related to accurate claims submission.
- Evidence of continuing education preferred.
Beyond the benefits that come with working for the area's leading community healthcare provider one that also recognizes the need to ensure patient safety and comfort you'll enjoy an extremely competitive compensation and benefits package. We are an equal opportunity employer and seek diversity in our workforce. EOE M/F/D/V