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CHA Hollywood Presbyterian Medical Center Patient Rep Biller - Emergency Department in Los Angeles, California

CHA Hollywood Presbyterian Medical Center

CHA Hollywood Presbyterian Medical Center (HPMC) is an acute care facility that has been caring for the Hollywood community and surrounding areas since 1924. The hospital is committed to serving local multicultural communities with quality medical and nursing care. With more than 500 physicians representing virtually every specialty, HPMC strives to distinguish itself as a leading healthcare provider, recognized for providing quality, innovative care in a compassionate manner.

HPMC is part of a global healthcare enterprise which owns and operates general hospitals throughout Korea, numerous research centers in the U.S. and Korea including a medical university, and CHAUM (a premier anti-aging life center).

Position Summary:

To review claims for accuracy of information, expedite billings to all third party payers and patients, and when applicable, call to identify billing address.

  • Enhances professional growth and development through the participation in educational programs, staff meetings, in-services/workshops and successful completion and maintenance of required certifications of specialty areas.

  • Demonstrates the ability to determine the accuracy of pertinent medical, coding, eligibility, authorization, demographic and financial information, and institute any required corrections.

  • Determines payer documentation requirements for payment, and insures that they are available to be submitted with the claim.

  • Transmits/submits clean claims to payers, within three working days of receipt. (Standard is 200 claims per day.)

  • Updates computer system to reflect submission/transmission of claims.

  • Reviews correspondence submitted by the payer, and provides correction and/or documentation within three working days.

  • Reviews payment data for suspension, underpayment, and denials and submits appropriate response. (i.e. CIF, re-bill, etc.).

  • Reviews bi-monthly accounts receivable reports to identify claims which have been submitted and either not resolved or acknowledged, and claims which have not been submitted. Takes appropriate action to insure resolution.

  • Prepares adjustments required to insure that balances reflect payable amounts, and forwards to management for review and authorization.

  • Demonstrates a complete understanding of department equipment and proper usage.

  • Promotes customer service through active communication, understanding their needs and concerns and providing resolution with tact, diplomacy and sensitivity.

  • Contributes to the team effort by remaining flexible and open minded, maintaining cooperative working relationships, sharing resources and information, and assisting co-workers in time of need.

  • Actively keeps up to date with developments in the industry by reading material provided by payers and/or management, attending seminars and using contacts in the industry.

  • Demonstrates the ability to make sound, productive and ethical decisions in the performance of assigned duties.

  • Demonstrates a commitment to quality and excellence.

  • Complies with departmental and hospital policies and procedures.

  • Reports to work on time and is at work station ready to begin work at the scheduled start time.

  • Attendance is within standard.

  • Maintains confidentiality of department and medical center information.

  • Exhibits appropriate telephone/fax/beeper protocol, i.e. answers promptly, identifies name and department and is courteous and helpful, and has knowledge of commonly used extensions.

  • Incorporates medical center’s mission of “quality care with compassion and respect” into daily performance of job functions.

  • Takes into consideration the age specific needs of the geriatric patient assuring communications are understood, repeats and questions comments as well as any special physical needs.

  • All other duties as assigned.

Minimum Education:

  • High School diploma.

Preferred Education:

  • N/A

Minimum Work Experience and Qualifications:

  • Ability to communicate effectively verbally and in writing.

  • Knowledge of payer requirements and medical terminology

  • 30 wpm typing and the ability to operate all department equipment and software programs

  • Three (3) years billing experience in a hospital setting

Preferred Work Experience and Qualifications:

  • N/A

Required Licensure, Certification, Registration or Designation:

  • Fire Card

Disclaimer, Compliance and Service Language:

DISCLAIMER: The above statements are intended to describe the general nature and level of work being performed by incumbents assigned to this job. This is not intended to be an exhaustive list of all the responsibilities, duties and skills required. The incumbent may be expected to perform other duties as assigned.

COMPLIANCE & INTEGRITY: Consistently supports compliance and the Hollywood Presbyterian Medical Center's Code of Conduct by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licensure requirements (if applicable), and Hollywood Presbyterian Medical Center's policies and procedures.

Models and reinforces ethical behavior in self and others in accordance to the Code of Conduct; adheres to organizational policies and guidelines; supports compliance initiatives; maintains confidences; admits mistakes; conducts business with honesty; shows consistency in words and actions; follows through on commitments. All Directors, Managers and Supervisors are accountable for communication, implementation, enforcement, monitoring and oversight of compliance policies and practices in their departments.

SERVICE & QUALITY: In addition to defined technical requirements, accountable for consistently demonstrating service behaviors and principles defined by the Hollywood Presbyterian Medical Center, as well as specific departmental/organizational initiatives. Also accountable for consistently demonstrating the knowledge, skills, abilities, and behaviors necessary to provide superior and culturally sensitive service to each other, to our patients, and to purchasers, contracted providers and vendors.

WORKPLACE SAFETY: In addition to defined working conditions and physical requirements, employees are accountable for working safely; following established policies & procedures; utilizing all designated protective personal equipment (PPE) and/or safety equipment assigned for task; and reporting all injuries and hazards to their supervisor immediately. Supervisors and Managers are accountable for ensuring the safety performance of employees; applying consistent practices in compliance with federal, state and local regulations; providing guidance to maintain a safe and healthy work environment.

Hollywood Presbyterian Medical Center is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the Los Angeles Fair Chance Ordinances.

LI-LW1

Requisition ID: 2020-2233

Shift: Day

External Company URL: www.hollywoodpresbyterian.com

Street: 1300 N Vermont Ave

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