Job Details

PFS Patient Account Rep at CHOC Children's

Work Location

Orange, California

Work Shift

Day – 08hrs (United States of America)

Job Summary

The Patient Account Representative is responsible for working with insurance companies, state agencies, and patients or parents in resolving account balances. Will research insurance billing and adjustment identification to ensure proper account resolution. Must have knowledge of all aspects of insurance claim filing and collection regulations, and understand payer remittance documents as well as regulatory guidelines or contracts that result in a reduction of billed charges. The role relies on guidelines established by the department and organization to perform job functions and work under general supervision in a moderately fast paced environment.

Pay Range

Minimum $21.98 Midpoint $29.13 Maximum $36.28

Rate of pay is determined by various factors, including but not limited to knowledge, skills, competencies, experience, education, as well as position requirements.

Experience

• Required: Minimum one (1) year of experience with billing and follow-up of Hospital / Physician claims. Knowledge of paper and electronic billing.

Education

• Required: High School Graduate/ GED or equivalent.
• Preferred: Some college or specific course related study.

Training

• Required: Working knowledge with Medicare, Medi-Cal, CCS, Cal-Optima, Private, PPO and HMO. Knowledge of CPT and ICD-10 Coding, understanding of payer contracts.

Specialized Skills

• Required: Knowledge of computer systems and software used in functional area. Ability to prioritize and complete duties in a timely manner to accomplish both individual and team goals. Open to change and be able to problem solve; supply input and participate in team meetings. Strong attention to detail, vigilance, poise, and composure in stressful situations.

Licensure

• Required: None required.

Work Environments - Functional Demand

Sedentary - Very light energy level. Lift 10 lbs. box overhead. Lift and carry 15 lbs. Push/pull 20 lbs. cart.

Physical Activity Requirements

Bending, Carry Objects, Climbing, Keyboard use/repetitive motion, Pinching/fine motor activities, Push/Pull, Reaching forward, Reaching overhead, Sitting, Squat/kneel/crawl (Squad & Knee), Standing, Talk or hear, Taste or smell, Twisting, Walking, Wrist position deviation

Physical Activity Lifting

Lifting (Floor to waist level) - Constant 67 or more%, Lifting (Floor to waist level) - Frequent 36-66%, Lifting (Floor to waist level) - Occasional 0-35%, Lifting (Waist level and above) - Constant 67 or more%, Lifting (Waist level and above) - Frequent 36-66%, Lifting (Waist level and above) - Occasional 0-35%

Sensory Requirements

Color Discrimination, Depth Perception, Far Vision, Hearing, Near Vision

Environment Requirements

Airborne Communicable Disease, Bloodborne Pathogens, Chemical, Dust Particular Matter, Extreme Noise Levels, Extreme Temperatures, Radiation, Uneven Surfaces or Elevations

Non-Discrimination Statement

CHOC does not discriminate on the basis of age, race, color, religion, national origin, ancestry, marital status, genetic information, disability, sex, gender (including pregnancy, breastfeeding, childbirth, lactation or related medical conditions), gender identity or expression, medical condition, sexual orientation, veteran status, military or uniformed service member status, or other protected characteristics in accordance with state and federal laws. CHOC will consider for employment qualified applicants with criminal histories, in accordance with the Fair Chance Initiative for Hiring.
We encourage individuals from all backgrounds to apply for positions at CHOC, even if your experience doesn't align perfectly with the listed qualifications for a particular role, as your unique experience may be a great addition to our culture for another one of our opportunities.
If you desire support or accommodations throughout the Talent Acquisition process, please inform your Talent Acquisition Partner.

Seniority level

Entry level

Employment type

Full-time

Job function

Health Care Provider

Industries

Hospitals and Health Care

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