Associate Billing Representative Clerk

Job Description

Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of high-quality outcomes and a better experience for patients and providers, all at a lower total cost of care.

As part of Optum, we participate in an integrated care delivery system that enables us to support our partners as they navigate a complex healthcare environment, Only SCA Health has a dynamic group of physician-driven, specialty care businesses that allows us to customize solutions, no matter the need or challenge:

• We connect patients to physicians in new and differentiated ways as part of Optum and with our new Specialty Management Solutions business.
• We have pioneered a physician-led, multi-site model of practice solutions that restores physician agency by aligning incentives to support growth and transition to value-based care.
• We lead the industry in value-based payment solutions through our Global 1 bundled payment convener, that provides easy predictable billing to patients.
• We help physicians address everything beyond surgical procedures, including anesthesia and ancillary service lines.

The new SCA Health represents who we are today and where we are going—and the growing career opportunities for YOU.

** The work schedule will be Monday - Friday with hours anywhere between 9am - 8pm EST / 8am - 7pm CST / 6am - 5pm PST **

The Associate Billing Representative Clerk takes coded patient visits and enters the charges into the systems, submits the claim to the insurance company, and works on rejections they may receive with our A/R collections team. The medical biller position works in the revenue cycle department at our regional business office and works closely with our collections team.

• Pull information from the system and enter the charges, make any adjustments, utilize internal databases, optimize the codes and submit the claim electronically or by paper
• Prepares and completes claims for commercial insurance companies, third party organizations and/or government or self-payers
• Complete billing rejections and make corrections as needed
• Follow up on pending claims and work them to resolution
• Review the variance report and identify and report any trends found
• Consistently achieve defined metrics

Required:

• High school diploma or GED
• Minimum one-year medical billing experience
• Thorough understanding of medical terminology and medical coding
• Thorough understanding of Commercial, Medicare and Worker's Compensation insurances
• Working knowledge of MS Office including Word, Outlook, and Excel

Preferred:

• Associate Degree, diploma, or certificate in medical billing & coding, healthcare management, or related program
• Two or more years of medical billing experience
• Prior experience with HST helpful but not required

• Prior experience in Cerner and Epic systems is Preferred

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