Performant Corporation is an Equal Opportunity Employer (Minorities/Females/Disabled/Veterans).

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Healthcare Billing & Collections Agent
Job Code:2019-50-2-001
Location:Lathrop, CA
Status:Regular Full Time
Performant is a market leader that recovery services for healthcare.  We’re more than brick and mortar – we are about helping people. It’s a dynamic, fast-paced and fun workplace like a start-up, but with the backing of a profitable public company with a history of growth.

We are looking for highly-skilled, talented medical billing  and collections specialists with strong knowledge of medical claim billing, forms UB04, UB05 and CMS 1500, medical terminology and medical coding, Coordination of Benefits and Third Party Liability (COB/TPL) and procedural challenges regulations; experienced in generating or auditing medical claims and billing; proven ability to gather and interpret Explanation of Benefits (EOB) to answer questions and resolve medical billing issues; and communicate effectively with carriers to recapture payments. 

As a Healthcare Billing and Collections Agent you will be assigned client carrier accounts with responsibilities to include, but not limited to:
•Contact Healthcare Insurance carriers and/or providers regarding improperly paid claims
•Educate Healthcare Insurance carriers and/or providers on their obligation to pay
•Ability to analyze and understand written communication from insurance companies including explanation of benefits.
•Support internal groups or functions with gathering and interpretation of the billing and collections work to development with knowledge base and understanding of key concepts and terminology in healthcare billing and claims
•Effectively follow and contribute to continuous improvement of scripts, guidelines and other tools provided to have professional conversations with Healthcare Insurance carriers and/or providers
•Efficiently and diligently work through assigned inventories to meet productivity metrics assigned by management.
•Leverage your knowledge and expertise to research Coordination of Benefits or underpayments and  answer questions and/or provide information that will bring to successful resolution and payment
•Initiate applicable action and documentation based upon provider/insurance carriers selected 
•Updates company systems with clear and accurate information such as point of contact, updated demographic information, notes from contact from outbound and inbound calls and/or attempts, payment commitments, as well as account status updates as applicable
•Arrives to work on-time, works assigned schedule, and maintains regular attendance
•Follows and complies with company and departmental policies, processes and procedures
•Responsible for utilizing resources to ensure compliance with client requirements, HIPAA, as well as applicable federal or state regulations
•Successfully completes, retains, applies and adheres to content in required training as assigned 
•Consistently achieve or exceed established metrics and goals assigned
•Demonstrates Performant core values in performance of job duties and all interactions
•Correct areas of deficiency and oversight received from quality reviews and/or management

Other Duties
Performs other duties as assigned.

Why you’ll want to join
You want to make a difference for yourself and others.
You’re not looking for a job, you want a career 
You learn quickly and are adaptable – we provide paid training.
You are committed to excellence in all you do – quality and reliability are part of our core values. 
You want to be part of a team that works hard and celebrates achievement - People are the key to our success. 

Performant offers a competitive benefits package:
•Core health benefits- Medical, Dental and Vision
•Company-paid Life and AD&D
•Other health benefit programs include supplemental Life, AD&D, short-term and long-term disability, Accident and Critical Illness, Identity Theft, and Flexible Spending Accounts
•Employee Assistance Plan
•Health Advocate Services
•Beyond Work discount products and services
•Additional benefit programs
•11 paid holidays
•Paid sick leave
•Paid vacation
•401K program

Required Skills and Knowledge:
To perform this job successfully, an individual must be able to perform each essential function satisfactorily. Below are representative of the knowledge, skills and abilities required:

•Knowledge and experience with medical claim billing procedures, medical terminology and medical coding
•Familiarity with information in the UB04/UB05 and CMS 1500 billing forms
•Experience with Coordination of Benefits and Third Party Liability and Procedural Challenge regulations
•Proven ability to gather and interpret Explanation of Benefits (EOB) and answer questions and resolve issues with payment
•Communicate professionally and effectively with providers, insurance carriers and third party agencies regarding mistaken payments 
•Experience in handling health insurance collections, including Medicare and Medicaid claims
•Protected patients’ privacy, understands and adheres to HIPAA standards and regulations 
•Interpersonal and communication skills; ability to listen, be succinct and demonstrate positive customer service attitude
•Capacity to share knowledge and educate others on healthcare billing and collections in relation to terminology, procedures, and related information
•Self-motivated and thrives in a fast-paced office environment performing multiple tasks cohesively, with keen attention to detail
•Proficiency using standard office technology; computer, various applications and navigation of on-line tools and resources, keyboard, mouse, phone, headset.
•Ability to follow process, procedures and regulations in the workplace.
•Ability to effectively perform work independently, and work cooperatively with others to promote a positive team environment.
•Capable of adapting quickly and transition effectively to changing circumstances, assignments, programs, processes.
•Ability to consistently perform job responsibilities.
•Possess a personality type that is ethical, friendly, hard-working and proactive.

Physical Requirements:
•Job is in a busy standard office environment with moderate noise level, sits at a desk during scheduled shift, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a mouse. Reads and comprehends information in electronic (computer) or paper form (written/printed).
•Sit/stand 8 or more hours per day; has the option to stand as needed while on calls; reach as needed to use office equipment
•Consistently viewing a computer screen and types frequently, but not constantly, using a keyboard to update accounts
•Consistently communicates on the phone with account holders, may dial manually when need or use dialer system; head-set is also provided
•Occasionally lift/carry/push/pull up to 10lbs.
Education and Experience:
•Minimum 2 years of medical billing and collection experience demonstrating depth of knowledge and capability required for the position. 
•High School diploma or GED