Billing Follow Up Associate (Government)

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.

Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.

Job Summary:

Communicates with patients, government agencies and third party payers to gather, process and record information to receive appropriate reimbursement. Obtains charge information, coding, data entry. Completes billing and collection processes and prepares for distribution to appropriate sources. Works on routine assignments within defined parameters, established guidelines and precedents. Follows established procedures and receives daily instructions on work.

Job Requirements:

Education and Work Experience:

• High School Education/GED or equivalent: Preferred
• Associate's/Technical Degree or equivalent combination of education/related experience: Preferred
• Medical billing and collections experience: Preferred

Essential Functions:

• Ensures all required forms, ID, insurance cards, etc. are obtained, completed, signed, and forwarded to the appropriate individuals/departments.
• Reviews status of unpaid accounts and resubmits claims or responds to payment delay. Submits Claim Inquiry Forms (CIF) when appropriate. Monitors reports of unbilled, unpaid and denied accounts. Utilizes appropriate system to prioritize account follow-up and denial reason code entry.
• Process Medicare and Medical billable claims (UB and 1500). Document reasons for unbillable accounts and forward to manager/ government supervisor for intervention and assistance. Responds to intermediary claim development requests (ADRs) and (RTDs) documents and submits within the timeframes provided by the requestor.
• Documents RCI using appropriate action item for quality control and training opportunities. Submits all non-covered write offs prior to billing. Ensures compliance issues are audited and resolved prior to billing. Manages accounts until balance is paid, becomes patient portion and resolve any credit balances.
• Generates letters. Enters and sorts data.
• Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.

Adventist Health is a faith-based, nonprofit, integrated health system serving more than 90 communities on the West Coast and Hawaii with over 400 sites of care, including 26 acute care facilities, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of 37,000 includes employees, physicians and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.