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Payroll Analyst

San Diego, CA

Order: 73726

We are looking for a Reimbursement Specialist to join a medical device company in the Sorrento Valley area. You will be responsible for processing claims, while working with medical insurance companies regarding coverage and claims. The ideal candidate, is someone who can effectively communicate over the phone with customers and insurance companies to resolve inquires per company policy.

Top Skills

  • Familiarity with CMS 1500 claim form preferred

  • Ability to understand Explanation of Benefits (EOB’s)

  • Knowledge of billing codes and modifiers assigned by the Centers for Medicare and Medicaid Services

Job Duties

  • Review and submit accurate claims, resubmissions and claim review forms

  • Handle incoming calls from customers, and place outgoing calls to patients and healthcare partners

  • Contacts patients regarding collection of outstanding invoices

  • Document calls in CRM tracking system and provide up to date patient claim information

  • Handle/escalate calls per established guidelines and procedures

  • Conduct insurance research on behalf of patients to determine if they are eligible for prescribed therapy

  • Negotiates structured payment plans

  • Ensures work is performed in compliance with company policies including Privacy/HIPAA and other regulatory, legal, and safety requirements

  • Other duties as assigned

 

Education/Qualifications

  • Bachelor’s Degree or equivalent combination of education and applicable job experience.

  • 2 years’ plus experience in medical billing

  • Proficient with Experience with MS Office suite (Word, Excel, and Outlook)

  • Computer/Internet savvy; Customer relationship management systems (CRM) is a plus

 

NOTE: Candidates that are offered a position are required to pass pre-employment drug and background screening. Qualified candidates with criminal histories, are considered in a manner that is consistent with local, state and federal laws

 

 

If this sounds like the position you are looking for, please send your resume to Adriana Mejia at amejia@suna.com