Claims Review Specialist - Accounting

Hi,

Hope you are doing great.

I am Pradeep Singh from SDK Soft Inc(Siri Info Solutions). Siri Info Solutions is a staffing firm with a heritage of over 16 years of partnership with Fortune 500 clients globally.

We have an immediate opening for a position of Claims Review Specialist in Los Angeles, CA with one of our premium clients. if you are available and interested, please send me your updated resume. For more information contact me at 848-209-8314.

Job Title: Claims Review Specialist

Length of Assignment: 6 months with the strong possibility of extension

Shift: 8:00 am - 5:00 pm -includes a 60 min break (M-F)

Location: Los Angeles, CA

Job Description:

Exp: 5+ yrs exp with hospital billing systems and third-party billing requirements, Bachelor's Degree, coding certification

Take on a significant role within a world-class health organization. Elevate the operational and financial effectiveness of a complex health system. Take your professional expertise to the next level. You can do all this and more at UCLA Health.

You will leverage your extensive theoretical revenue cycle knowledge as you take on a vast range of critical revenue issues. This will involve applying dashboards and processes for continuous analysis of complex revenue cycle functions while also auditing data input for all components of revenue cycle management. You will:

• Analyze complex financial data
• Identify trends in revenue cycle operations
• Summarize data and present reports to leadership
• Serve as liaison with departments to thoroughly define reporting and information requirements
• Evaluate revenue cycle workflows to identify areas for improvement
• Oversee charge integrity, reconciliation, and charge linkages from ancillary charging systems
• Train patient financial services units on revenue cycle systems, processes and procedures
• Maintain compliance with government regulations, reimbursement issues, etc.
• Analyze hospital billing claims within the EHR and claim scrubber system
• Resolve claim errors, edits, and other holds
• Works with clinical and ancillary operational departments on correct coding, billing, and charging principles

We're seeking a highly analytical, detail-driven professional with:

• Bachelor's degree in business, finance or related field
• CPC-H, CPC, or CCS coding certification
• Five or more years of experience with hospital billing systems and third-party billing requirements
• Experience in revenue integrity operations, clinical charge capture, charge master, or revenue cycle operations
• Proficiency with Microsoft Excel
• Knowledge of Tableau Reporting dashboards
• Understanding of Medicare/Medi-Cal claims processing guidelines
• Experience with EPIC EHR, Cirius Claim Scrubber, or other EHR system
• In-depth knowledge of the practices, procedures, and concepts of the healthcare revenue cycle
• Strong analytical and problem-solving abilities

• Excellent communication, interpersonal, and collaboration skills
• Proficiency in the use of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and revenue codes

If the Client extends an offer then you have taken care of the health screen process.

Vaccinations process- We will take care of the cost of Health screening and except MMR and Varicella.

Fit Test

x

Kimberly Clark/Halyard N-95. PAPR allowed.

Immunization Flu shot

x

Oct 1- March 31/ can be extended per facility- Subject to change.

Immunization / Titer - Hep B or Declination

x

Declination, proof of completed 3 series vaccine series, or positive titer.

Immunization / Titer - MMR

x

Vaccine record of 2 series or positive IgG titer.

Immunization / Titer TDaP

x

Vaccine within 10 years of start date; declination acceptable.

Immunization / Titer Varicella

x

Vaccine record of 2 series or positive IgG titer.

TB Test

x

Proof of a negative TB test (QuantiFERON only) done within a year of the assignment start date; if positive, evidence of a clear chest x-ray done within 3 months of start date must be provided and a questionnaire from a physician concerning no active TB must be provided along with the x-ray results.

US Citizen/Green Card candidates are encouraged to Apply

Thank you

Regards,

Pradeep Singh

Technical Recruiter

SDK Software Inc (Siri InfoSolutions Group)

(D) 848-209-8314

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