Medi-Cal Claims Biller

📋 Description

• • TruBridge is seeking a dedicated and detail-oriented Medi-Cal Claims Biller to join our dynamic team. In this crucial remote role, you will serve as a vital liaison between hospitals and clinics and TruBridge's Accounts Receivable Management Services. Your primary responsibility will be to ensure the accurate and efficient processing of hospital service receipts, meticulously verifying payment amounts, contractual allowances, and other remittance details.
• • This position demands a high level of precision and a proactive approach to problem-solving. You will be instrumental in maintaining the integrity of our clients' financial records by accurately posting payments, identifying and resolving discrepancies, and ensuring all transactions are correctly allocated.
• • A key aspect of this role involves receiving daily receipts that have been balanced and stamped for deposit. You will be responsible for verifying the total amount of each receipt and conducting thorough research on any receipts that lack clear posting instructions. This investigative work is essential for preventing errors and ensuring smooth financial operations.
• • Upon verification, you will meticulously post payments to the appropriate patient accounts. This includes not only monetary payments but also zero payments, ensuring that every transaction is logged and accounted for. Detailed notes will be required for any necessary follow-up actions, contributing to a comprehensive audit trail.
• • You will maintain a detailed log of all daily receipts and contractual allowances posted, providing a clear record of financial activity. This documentation is critical for reporting, auditing, and client reconciliation purposes.
• • A significant part of the role involves processing rejections. This may include making accounts private to prevent further billing or correcting identified billing errors and resubmitting claims to third-party insurance carriers. Your expertise in this area will directly impact our clients' revenue cycle.
• • Consistently meeting and exceeding production and quality assurance standards is paramount. You will be expected to manage your workload effectively, prioritize tasks, and maintain a high level of accuracy in all your postings and data entry.
• • Maintaining excellent customer service is a core tenet of this position. You will adhere to company policies and procedures, as well as the specific protocols of each client, ensuring a professional and reliable service.
• • Continuous learning is encouraged. You will update your job knowledge by actively participating in company-offered education and training opportunities, staying abreast of industry best practices and system updates.
• • Protecting customer information is non-negotiable. You will be entrusted with sensitive financial data and must maintain strict confidentiality at all times, adhering to all data privacy regulations.
• • You will be responsible for processing miscellaneous paperwork, which may include various administrative and financial documents requiring careful handling and accurate filing.
• • This role may require you to work with high-profile clients who may have complex or challenging processes. Adaptability and a calm, professional demeanor are essential when navigating these situations.
• • You may be regularly asked to contribute to team projects, collaborating with colleagues to achieve departmental goals and improve overall service delivery.
• • A minimum of 3 years of hospital payment posting experience, including time spent outside of TruBridge, is required. This experience should provide you with a solid foundation in healthcare billing and payment processes.
• • A detailed understanding of CAS codes is essential for accurate claim processing and denial management.
• • You will be responsible for posting denials to patient accounts, ensuring the correct denial reason code is applied for proper tracking and appeal.
• • The ability to post patient payments, electronic insurance payments, and manual insurance payments accurately is a core function of this role.
• • Balancing all payments and contractual allowances daily is critical to ensure financial accuracy. This includes making sure all postings balance precisely with the site's bank deposit.
• • You must adhere to site-specific productivity requirements as outlined by management, demonstrating efficiency and reliability.
• • You will serve as a valuable resource for other receipting service specialists, sharing your knowledge and assisting colleagues when needed.
• • Agility and the ability to easily shift between various tasks are crucial in this fast-paced environment.
• • Overtime may be required as needed to ensure the day/month are fully balanced and closed, demonstrating your commitment to meeting deadlines.
• • You will assist with backlog receipting projects, such as resolving unresolved situations in Thrive, researching credit accounts, and reconciling unapplied payments, contributing to the overall efficiency of the accounts receivable process.