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Medical Reimbursement Rep- Payment Integrity/Refund I 820289

Cerritos, CA 90703

Posted: 01/15/2025 Job Category: Healthcare Job Number: 820289 Pay Rate: $24 - $26 per hour

Job Description

Company in the Cerritos area is looking for someone who has experience with Medical Reimbursement Payment, Accounts Receivable, Collections. 

Job Title: Medical Reimbursement Representative - Payment Integrity/Refund I 

Pay Rate: $26.00 

Major Duties: 
  • Assures Billing processes are compliant with payer requirement for Government Commerical Health Plans and Medical Group payers 
  • Escalate credits to Level II Payment Integrity/Refund Representative, Sr. Payment Integrity /Refund 
  • Analyze and rectify claims issues with payers by timely follow up of correspondence/refund letters received from payers
  • Reviews and assures claims are processed and paid in full according to contractual agreements 
  • Ensures revenue is booked according to approximate contract allowable 
  • Handles calls regarding refund requests promptly with professionalism  to payers 
  • Protect patient health information by following regulations for HIPPA compliance 
Education: 
  • High School Diploma or equivalent education 
  • Candidate must be experienced with a minimum of 1 year or greater (not including  school or externship ) 
  • Candidate must be a self-starter and motivated to research and resolve issues 
  • Strong understanding of insurance terms, medical terminology, pricing  methodologies for commercial and government billing requirement 
  • Medicare knowledge 
  • Microsoft Word and Excel 
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About Cerritos, CA

Ready to kickstart your career in Cerritos, California? This vibrant city in Los Angeles County is a hub of opportunity and growth! With its close proximity to the coast and iconic landmarks like the Cerritos Center for the Performing Arts, this region balances suburban tranquility with urban flair. Explore job listings in this dynamic area and discover a community known for its diverse cuisine, art galleries like the Cerritos Sculpture Garden, and scenic parks such as Heritage Park. Join the professional scene here and experience the charm of Cerritos while advancing your career. Let's find your perfect match in Cerritos, CA!