PRIDE Health
Costa Mesa, CA, USA
Pride Health is hiring a Medical Biller to support our client's medical facility based in Costa Mesa, California .This contract opportunity is a great way to start working with a top-tier healthcare organization! Responsibilities: Act as the account representative for Hoag, working with insurance companies, government payors, and patients to resolve payments and accounts. Complete assigned accounts and ensure maximum reimbursement by evaluating claims at contract rates (APC, DRG, APRDRG). Initiate appeals for underpayments and follow timely requirements to secure reimbursement. Review and respond to payor and patient correspondence in a timely manner. Escalate accounts requiring appeals due to billing, coding, or underpayment issues. Report new billing edits for review and resolution. Understand Revenue Cycle processes, managed care contracts, and payor rates, including Federal and State requirements. Interpret Explanation of Benefits (EOBs) and Electronic...