Billing and Collections Rep I
Rady Children's Hospital - Children's Center - San Diego, CA

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Under the direction of the Supervisor, Professional Billing & Coding, receives charge batches for verification and pre-coding. These batches will be received directly from the clinic or hospital care area via the electronic medical record system. Paper charge tickets will be received for non- RCHSD locations. Using IS system reports, ensures that all expected charges are received from providers. Verifies authorization when necessary for patients visit and procedures and verifies such numbers are present in the billing system. Registers new patients into IS system, including patient demographics, insurance and claim information. Verifies appropriate use of CPT and ICD-9 codes and modifiers for all charge sessions/encounters. Responsible for daily processing of claim edits for rejected claims processed through electronic claim vendors. Provides professional customer service to patients by answering billing questions via telephone and written correspondence. Is responsible to log into the department phone system following department policies and procedures. Responsible for pulling medical records to submit with claims, appeals and as required by payors. Assists with other related duties as assigned.

MINIMUM QUALIFICATIONS:

High School Diploma, GED or foreign equivalent

1 year of experience

Medical Billing experience

EOE/M/F/D/V

HR Use Only:

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