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Patient Accounting Payment Reviewer - EOB Reviewer

Location: Santa Ana
Posted on: May 27, 2023

Job Description:

SUMMARYUnder the direction of the Collections Supervisor/Manager, the EOB Reviewer will perform his/her duties in accordance with CBO guidelines. REQUIREMENTS RESPONSIBILITIES AND DUTIES:Demonstrates competency in the quality of work and knowledge of the job pertinent to the functioning of EOB Reviewer.Ensure all discounts are applied to each account as specified in each contract.Enter all correspondence/EOBs received into the computer.Update patient demographics, including insurance company information and financial class changes.Keep EOB review and interpretation current.Transfer charges or insurance payments when appropriate.Send accounts to audit as requested by patients or insurance companies.Research information by phone for other departments within the hospital.Send requests to Health Information Services for requested information, i.e. ER reports, operative reports, etc to designated Hospital. .Update patient responsibility in (MU) Screen and send patient a CEBPL when applicable.Request Manual Move to Pay and adjustments on accounts when applicable.Request clinical appeals when applicable.Submit Provider Disputes to insurances when applicable.Verifies Mcare/Mcal/Calop eligibility when applicable.Assist with special projects.All other assigned duties.EDUCATION & EXPERIENCE REQUIREMENTS:Minimum of 2-5 years' experience in hospital billing of an acute care facility or equivalent of other work experience.High school diploma required.SKILLS & ABILITIES REQUIREMENTS:Ability to type 40 words per minute.Good oral communication skills are required to discuss payment adjudication with insurance companies.The posted pay scale represents the range the Company reasonably expects to pay candidates for this position. The actual wage for this position may depend on factors such as experience and education, specific skills and abilities, alignment with similar internal candidates, marketplace factors, an applicable collective bargaining agreement, and Company business practices.

Keywords: KPC GLOBAL MEDICAL CENTERS INC., Santa Ana , Patient Accounting Payment Reviewer - EOB Reviewer, Accounting, Auditing , Santa Ana, California

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