Patient Financial Services Billing Specialist
Company: Alameda Health System
Location: San Leandro
Posted on: June 8, 2021
The PFS Billing Specialist is responsible for all aspects
reviewing charges for claims and performing third party billing
activity for hospital services. Candidates will need to have a
strong understanding of billing codes and guidelines for Medicare,
Medi-Cal, and health insurance. In addition to having a strong
knowledge in State and Federal rules and regulations. There are two
The following are the duties performed by employees in this
classification. However, employees may perform other related duties
at an equivalent level. Not all duties listed are necessarily
performed by each individual in the classification.
- The PFS Billing Specialist is responsible for all aspects of
billing primary, secondary, and tertiary payers for AHS facility
claims including: Identifying issues or trending and provide
suggestions for findings and claims activity performed. Review the
account information and necessary system applications to determine
the next appropriate work activity. Verify claims have passed edits
utilizing appropriate resources and applications. Perform
appropriate billing functions, including manual re-bills as well as
electronic submission to payers. Edit claims to meet and satisfy
billing compliance guidelines for electronic submission. Manage and
maintain worklist inventory, complete reports, and resolve high
priority and aged inventory.
- Respond timely to emails and telephone messages as appropriate.
Communicate issues to management, including payer, system, or
escalated account issues.
- Maintains information or operational records; screens reports
for completeness and mathematical accuracy; list, abstracts, or
summarizes data; compiles routine report from a variety of
- May, as a secondary responsibility, review notes, receipts,
permits, licenses, etc; computes and receives fees when the amount
is not in question or is readily obtainable from fixed schedules;
posts data; keeps records, and prepares reports in accordance with
pre-determined forms and procedures.
- Prepares billing documents for collection of revenues from
third party payer programs and patients; checks and verifies charge
rates for services; reconciles patient account balances verifies
- Reviews billing documents to assure program compliance for
Medicare, Medi-Cal, Mental Health, and insurance programs; assures
that all appropriate medical documentation is included in the
- Other duties as assigned.
Any combination of education and experience that would likely
provide the required knowledge, skills, and abilities as well as
possession of any required licenses or certifications is
Required Education: High school diploma or equivalent
Minimum Experience: One year of experience in a Revenue Cycle
area within the Alameda Health System; OR the equivalent of two
years' experience, performing medical billing or medical accounts
receivable functions in a healthcare insurance related
Keywords: Alameda Health System, San Leandro , Patient Financial Services Billing Specialist, Other , San Leandro, California
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