CEP America
Refunds Specialist
Operations
Billing
California - Modesto
Modesto, CA
Full Time

Why MBSI?

MBSI is one of the top employers of Stanislaus County providing medical billing, coding, and reimbursement services along with various reports to MedAmerica a leading healthcare price management organization.  MedAmerica Billing Services, Inc. (MBSI) has been in the physician billing business since 1975. MBSI has continued to expand and now has 2 additional locations including an office in Ontario, CA as well as Scottsdale, AZ.

MBSI has adapted to the ever-changing medical billing environment, modifying and adding to its services to proactively meet the needs of its clients. A focus on physician and employee education coupled with advanced IT capabilities has positioned MBSI and its clients to operate successfully in a climate of increased governmental regulations, third party contracting and reimbursement challenges.

Summary:

Analyzes all correspondence and EOBs pertinent to patient accounts for prompt and accurate reimbursements to Insurance carriers, government contractors and patients. Reimbursing credit balances adhering to State and Federal guidelines. Prioritizes assigned accounts through Activity Code Tracking Services (ACTS) to meet daily, weekly and monthly team/company goals. This is a non-exempt position and reports directly to Department Supervisor.

Essential Job Functions, non-inclusive:

Employees must be able to react to change productively, work overtime as requested or required and handle other essential functions as assigned.


  •   Reviews credit balances for (1) one State and/or Specialty team.

  •   Reviews refund request letters to determine appropriate resolution

  •   Issues refund request denial letters based on contract and timely guidelines.

  •   Researches government claims to ensure that accounts are coded according to government      guidelines.

  •   Reviews accounts to ensure payments were posted correctly.

  •   Contacts insurance companies and patients regarding accurate billing information.

  •   Determines and assigns financial classification.

  •   Adheres to procedural guidelines to apply designated ACTS codes and AB1455 Payment Dispute   Resolution codes as necessary.

  •   May be asked to travel for business reason, not exceeding 3% of time.

Additional Job Functions (Not required, rather preferred)


  • Employees may be required to perform these functions.  However, the ability to complete these duties is not essential to successful job performance.

  • Payment posting and/or par report

  • Other duties as assigned

REQUIREMENTS:


  • Must be able to perform 10-key by touch.

  • Must be able to type a minimum speed of 45 words per minute or 6,000 data entry key strokes per hour.

  • Must possess excellent verbal and written communication skills.

  • Must have confidence and ability to make collection calls.

  • Must possess strong interpersonal skills to work within a team environment.

  • Must be able to demonstrate effective customer service skills with internal and external customers.

  • Possesses strong organizational skills to plan, analyze and interpret statistical data.

  • Communicates with internal and external customers for purpose of resolving overpayment reimbursement.

  • Must be proficient in Excel and Word.

  • Ability to analyze and interpret statistical data

  • Must have a high level of flexibility and the ability to adapt to changing priorities.

  • Must have the ability to perform various tasks simultaneously.

PREFERRED ~ NOT REQUIRED:


  • AA degree

  • Two years of medical billing and/or payment posting experience

What We Offer Our Most Valuable Asset, Our Employees:

We offer the opportunity to help positively impact the healthcare industry while enjoying an amazing benefits package and work environment.

Competitive benefits package:  Multiple health plan options or reimbursement for non-coverage, exceptional 401k plan (that includes a very generous company match), 2 weeks paid vacation, sick leave, tuition reimbursement, life insurance, discount on fitness centers and more.

A Culture of Caring: Friendly, caring, business casual environment.  Opportunities to learn or develop your skills. 

Our Philosophy: MBSI Cares

C  Client Centered

A Adapt as a Team

R  Responsive

E  Engaged

S - Supportive of Each Other

TEAMWORK MAKES THE DREAM WORK!   MedAmerica Billing Services, Inc. is an Equal Opportunity Employer.

 

Would you like to apply to this job?

Apply for the Refunds Specialist position


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