Transplant Billing Representative

General Information

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Work Location: Los Angeles, CA, USA Onsite or Remote Flexible Hybrid Work Schedule Monday - Friday, 7:00 AM - 4:00 PM Posted Date 11/01/2024 Employment Type 2 - Staff: Career Duration Indefinite Job # 29266 Primary Duties and Responsibilities

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As a Transplant Billing Representative, you will manage a designated portfolio of inpatient and outpatient transplant accounts, ensuring accurate claim preparation and timely reimbursement. Your primary responsibilities include:

• Reviewing and preparing inpatient and outpatient transplant claims based on payer type and billing requirements
• Submitting claims to commercial, government, and self-pay payers in compliance with billing regulations and timely filing guidelines
• Editing claims to ensure accurate coding, documentation, and payer-specific requirements are met prior to submission
• Reviewing required documentation such as authorizations, medical records, and transplant-related invoices to support claim accuracy
• Managing assigned transplant accounts, including mid-to-high dollar balances, and responding to payer inquiries to support timely resolution

Salary Range: $26.79 - $38.05/hourly

Job Qualifications

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We are seeking a detail-oriented individual with:

• High school diploma or GED; Minimum of 3 years of related hospital billing or collections experience, including at least 1 year in billing investigation
• Associates degree in healthcare administration, finance, or a related field, preferred
• Knowledge of inpatient and outpatient hospital billing processes and claim submission requirements
• Ability to interpret payer billing rules and basic contract terms
• Working knowledge of UB-04 claim forms, CPT codes, HCPCS codes, and hospital billing data elements
• Experience using patient accounting or billing systems in a healthcare setting
• Proficiency in Microsoft Office, especially Excel and Word
• Strong organizational skills, attention to detail, and the ability to manage multiple accounts while meeting productivity expectations

As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.