Billing Rep III

Where You’ll Work

Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California, Arizona and Nevada. Today, Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers, we provide increasing support and investment in the latest technologies, finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled, qualities that are vital to maintaining excellence in care and service.

Job Summary and Responsibilities

As our Billing Rep III, you will help our patients and providers streamline the billing and insurance process so they can focus on patient care and financial well-being.Every day you will review and process patient accounts, insurance claims, and payment postings. You will be expected to ensure accurate and timely billing, follow up on denied claims, and maintain patient confidentiality.To be successful in this role, you must have strong attention to detail, knowledge of medical billing and coding, and experience with healthcare insurance.

• Demonstrate a solid understanding of your role as an Accounts Receivable Representative III to include: Read & interpret invoice details, Patient registration in IDX, Rejection posting in IDX, Knowledge of medical records systems, Ability to navigate Insurance payer web sites, Read & interpret EOB's from various insurance carriers, FSC knowledge, Rules of FSC Flipping *Rules of Charge Corrections, Understanding of claim edits
• Expert in Accounts Receivable (AR) processes, including invoice interpretation, patient registration, rejection posting, EOB analysis, and claim edits within IDX and medical records systems
• Manage AR inventory by analyzing system issues, payer denial trends, and identifying training needs
• Resolve unpaid claims through payer contact, denial analysis, and issue tracking/trending
• Collaborate with internal and external stakeholders (e.g., insurance carriers, medical foundation staff, Refund Analyst) to ensure accurate billing, collections, and resolution of overpaid claims
• Maintain data integrity by validating insurance information and resolving claim edits

Job Requirements

Required

• High School Diploma or GED
• Four (4) years experience working in healthcare Rev Cycle or a Professional Medical Office
• One (1) year experience with IDX Practice management system
• Knowledge of physician billing regulations
• Understanding of professional claims and billing procedures
• Excellent written and verbal communication skills
• Working knowledge of computers
• Demonstrated proficiency in email systems, internet and office software applications

Preferred

• Associates in Healthcare Administration or related field
• Six (6) years experience working in healthcare Rev Cycle or a Professional Medical Office
• One (1) year experience with Cerner EHR