DaVita Biller III in LOS ANGELES, California

Biller III

Description

DaVitaMedical Group manages and operates medical groups and affiliated physiciannetworks in California, Nevada, New Mexico, Florida, Colorado and Washington inits pursuit to deliver excellent-quality health care in a dignified andcompassionate manner. As of September 30,2016 DaVita Medical Group (formerlyHealthCare Partners) provided integrated care management for approximately750,000 patients. DaVita Medical Group’s leadership development initiatives andsocial responsibility efforts have been recognized by Fortune, ModernHealthcare, Newsweek and WorldBlu.

We arecommitted to bringing the benefits of coordinated care to our patients and totaking a leading role in the transformation of the national healthcare deliverysystem to assure quality, access, and affordable care for all.

Ifyou're looking to make a difference with a large, financially stable,well-recognized medical group, DaVita Medical Group may be the employer foryou.

Overview:

Responsiblefor providing leadership and support to other Billers and assisting in theday-to-day operations of the Business Office.

Essential Functions:

  • Consistently exhibits behavior and communicationskills that demonstrate HealthCare Partners’ (HCP) commitment to superiorcustomer service, including quality, care and concern with each and everyinternal and external customer.

  • Establishes daily department priorities and assignsduties to staff.

  • Ensures the timely submission of primary andsecondary claims.

  • Maintains current working knowledge of CPT and ICD-9codes, required modifiers and encounter data.

  • Performs electronic claims submission.

  • Maintains summary report notebooks and confirmationlogs.

  • Reviews insurance claim forms for accuracy and completeness. Makes necessary corrections.

  • Sorts and reviews payments received by the BusinessOffice.

  • Calculates insurance contract adjustments.

  • Prepares payments for data entry according toPayment Calculation policies and procedures.

  • Applies knowledge of Medicare and Medi-Calguidelines in reviewing claims to ensure appropriate use of modifiers andCPT/ICD-9 codes.

  • Corrects claims appearing on Edit Reports.

  • Maintains edit report binders.

  • Communicates system and claim formatting issues tothe I.S. department.

  • Serves as a resource to HCP staff on coding andgeneral billing guidelines.

  • Uses, protects, and discloses HCP patients’protected health information (PHI) only in accordance with Health InsurancePortability and Accountability Act (HIPAA) standards.

  • Performs additional duties as assigned.

Qualifications

EDUCATION:

  • High school diploma, G.E.D. or equivalent. Includes special certification required forspecific jobs.

  • CPC certificate preferred.

  • Some college education preferred.

EXPERIENCE:

Minimum:

  • Over 1 year and up to and including 3 years of relatedjob experience.

  • Experience with CPT/ICD-9 coding.

  • Previous supervisory or lead experience.

Preferred:

  • Over 5 years of medical billing and/or related jobexperience.

  • Previous computer experience (MSWord or other word processing programs).

  • HMO/managed care experience.

  • Previous IDX experience.

KNOWLEDGE, SKILLS, ABILITIES:

  • Computer literate.

  • Microsoft Word skills.

  • Knowledge of CPT and IDC-9 codes.

  • Working knowledge of business billing officeduties.

  • Working knowledge of Medicare and Medi-Calguidelines.

  • Knowledge of HMO and PPO claims requirements.

  • Good verbal and written communication skills.

  • Organized and detail-oriented.

  • Ability to work under time constraints.

  • Bilingual preferred.

Primary Location CA-LOS ANGELES - 90015

Req ID: 304328