Senior Insurance Billing Clerk-Patient Accounting-Billing (Riverside)

Full Job Description

The Riverside University Health System (RUHS) - Patient Accounting - Billing Division seeks to fill a Senior Insurance Billing Clerk position (located in Riverside).

Under general supervision, to lead and perform specialized and more difficult fiscal clerical work in connection with processing and billing fiscal intermediaries for medical services rendered to patients; and to do other work as required.

Incumbents in this class are responsible for functionally leading and planning the daily activities of Insurance Billing Clerks and Office Assistants as well as performing the more difficult billing procedures. This class is distinguished from the Insurance Billing Supervisor class in that incumbents in this class are not responsible for interpreting policies, rules, or regulations on billing related matters, or assisting in the coordination of procedures among various patient accounts systems.

This position performs hospital facility billing and collections, including denied claim follow-up, complex account resolution, and payor communication.

The role prepares appeals and correspondence, verifies patient insurance and eligibility, and provides guidance and support to staff on complex billing issues.

The position also serves internal and external clients and ensures accurate billing in compliance with regulations and contractual obligations.

The role includes performing hospital facility billing and collections, including complex account resolution and follow-up on denied claims. Responsibilities involve reviewing and interpreting payor contracts, regulations, and legal obligations, as well as drafting correspondence, dispute letters, and appeals for hospital billing and special programs. The position also requires verifying patient insurance coverage, eligibility, and authorizations, reviewing accounts for accuracy, responding to inquiries from patients, insurance companies, and internal departments, and initiating calls for billing follow-up while coordinating with internal and external stakeholders.

Additional duties include leading and training staff, serving as a resource for complex billing issues, and providing customer service support to internal and external clients. The role also involves reviewing and correcting data entry for billing claims, appeals, and reports to ensure accurate account records. Preferred qualifications include a high school diploma or equivalent, three years of hospital medical billing or collections experience, knowledge of hospital facility collections practices, and experience with Medi-Cal, Medicare, Managed Care, commercial, and government payors, as well as the Epic Patient Accounting system. Strong attention to detail, goal orientation, and effective written and verbal communication skills are required, with bilingual Spanish and a medical billing certificate preferred.

Work Schedule: Will be discussed during the interview (Tentative 9/80)
Work Location: 7898 Mission Grove Pkwy S, Ste# 200, Riverside, CA 92508

Meet the Team! Every day at Riverside University Health System Medical Center, a dedicated team of healthcare professionals and support staff come together to improve lives across Riverside County.

Our nationally recognized programs and specialized services thrive because of the diverse talents and commitment of our team members.

No matter your background or skill set, you’ll discover meaningful opportunities and a strong sense of purpose here.

To learn more about RUHS Medical Center, please visit www.ruhealth.org

Requirements

• Leads and trains staff; Serves as a resource for staff in the solution of difficult problems relating to procedures and regulations; Assists staff in resolving a variety of difficult problems.

• Checks and corrects bills and accounts for numerical accuracy, proper coding and prepares ATP's for data entry.

• Reviews patient accounts to determine the accuracy of account information and makes any required adjustments for proper billing purposes.

• Registers patients for medical services such as emergency treatment care and non-emergency walk-in treatment.

• Verifies billing account or insurance forms for completeness and accuracy against a variety of automated and manual records.

Qualifications

Experience: Two years experience performing fiscal, statistical and fiscal record keeping functions with at least one year involving third party intermediary medical billing.

Knowledge of: Methods and terminology of financial and statistical clerical work including knowledge of general clerical auditing and verification techniques; General billing, medical terminology, and billing forms with knowledge of the application of computerized accounting systems.

Ability to: Lead staff; Understand and apply rules and regulations pertaining to medical billing policies and procedures while identifying routine billing errors and differentiate between appropriate applications of various billing methods; Perform basic mathematical computations rapidly and accurately; Organize work to meet prescribed deadlines.

Additional Information

For further information regarding this posting, contact the recruiter: Anay Sanchez at anasanchez@rivco.org or call 951-955-5893. Due to the high volume of calls, please allow up to 2 business days to receive a response.