Job Summary: Medi-cal Patient Account Representative, Senior is responsible for all Medi-cal collections of accounts to ensure that PFS is capturing all revenues as timely and efficiently as possible.
Duties & Responsibilities:
Takes ownership of their accounts and eliminates barriers to ensure timely and correct payment including involvement with payors upper management, when necessary.
Must have working knowledge of Medi-cal including other complex payment methodologies to ensure prompt and accurate reimbursement.
Must be able to utilize and understand many complex and varying Medi-cal State and Federal statutes and regulations, guidelines and systems, and perform the billing and/or account follow-up function with all Medi-cal government agencies to obtain maximum and correct reimbursement of accounts receivables.
Works with all payors and internal resources to identify and resolve issues that hinder account payment.
Applies independent judgment and knowledge to audit Medi-cal payments, denials, appeals and billing issues.
Qualifications & Experience:
Minimum 3 years’ experience and understanding of Medi-Cal hospital collections processes required
Excellent interpersonal skills
Positive work ethics
Knowledge of medical terminology and coding, preferred
Written and verbal communication skills to meet productivity standards