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Medical Accounts Receivable Specialist

Company: Zymeda Provider Solutions
Location: Moreno Valley
Posted on: June 7, 2021

Job Description:

Come join our team!!! Zymeda is a small to mid-range company with a fun and relaxed work atmosphere! There are no drama llamas here! We know our teams are the backbone of our company and so we offer flex work schedules, business causal dress, remote work options, competitive pay and benefits, including vacation AND Paid Time Off! Check us out at

As an Accounts Receivable Specialist, we need your amazing skills, hard work, and natural determination to be responsible for daily and continuous monitoring of all payments. This means we heavily rely on you to ensure all claims are paid correctly from the registration process through post payments. Most importantly, you won't mind the ongoing monitoring and follow up for payment requirements in accordance with AB1455.

We care about our clients and we love the work we do! To help us be our best, we nurture our Team Culture as it is the moral fiber of who we are as a company and influences the customer service we provide. It also helps deflect possible burn out and makes sure you have what you need to do your job! All in all, we ask that our employees do their best, own their work, and use a high-degree of personal and professional accountability to service our client billing needs.

Essential Duties and Responsibilities include the following:

A big part of this job means we need you to coordinate ongoing participation and resolution of revenue and compliance issues as they arise. So, if you are amazing at looking for trends and providing your own independent analysis, then you may be the right fit! Let's take a look at what this job really entails:

  • Periodic auditing and validation of clearinghouse batches being processed from EMR.
  • Coding and documentation support level of care, proper modifiers are used, etc.
  • Performs various collection actions including denial management, contacting patients and insurance companies by phone, correcting and resubmitting claims to third party payers.
  • Claims are submitted based on payer guidelines, e.g., Medicare vs. MediCal, LCD (neurosurgery) documentation for Medicare, etc.
  • Working knowledge of medical terminology
  • Ability to understand and/or learn insurance contracts for billing and collection purposes
  • Ability to prioritize and handle multiple tasks and projects concurrently
  • Respond to correspondence, phone calls, patients and third party requests.
  • Analyze patient accounts for balances owed.
  • Establishes payment plans to help patients manage payment of bills.
  • Rebill insurance companies or other third parties to secure payment for patients.
  • Coordinate collection of outstanding monies not received during patient visits.
  • Generate collection phone calls and correspondence for billing.
  • Coordinate referral of bad debt accounts to collection agencies.
  • Prepare, review and send patient statements per client guidelines.
  • Updates job knowledge by participating in educational opportunities; reading professional publications and providing staff with ongoing updates and training inclusive of, knowledge of CPT and ICD-10 coding
  • Understands steps to escalation.

Overall, we hope you will always find ways to demonstrate your knowledge and proficiency in the principles, procedures, and best practices related to this position.

We believe that communication is important, so we would look to you to respond to correspondence, phone calls, patients, and third-party requests timely.

Of course, we want you to grow your skills and add to our awesomeness, so we look to you for updates of job knowledge by participating in educational opportunities; reading professional publications and providing staff with ongoing updates and training inclusive of, knowledge of CPT and ICD-10 coding.

And finally, part of a growing company means we need your brain and heart in the game! Sometimes, this means that we need extra help, and will ask you to perform other duties as needed.


We believe that if you are to be your best, we should do our best to set you up for success! So, for this position, we believe the following competencies are important for you to have, in order for you to succeed. They are:

Analytical - You use intuition and experience to complement the data.

Continuous Learning - You can assess your own strengths and weaknesses, which includes seeks feedback to improve your performance.

Job Knowledge - Competent in required job skills and knowledge; exhibits ability to learn and apply new skills.

Use of Technology - Demonstrates required skills; adapts to new technologies.

Problem Solving - Identifies and resolves problems in a timely manner; gathers and analyzes information skillfully; develops alternative solutions; works well in group problem solving situations.

Customer Service - Manages difficult or emotional customer situations; responds promptly to customer needs; responds to requests for service and assistance.

Communications - Expresses ideas and thoughts verbally; keeps others adequately informed.

Cooperation - Exhibits tact and consideration; works cooperatively in group situations.

Oral Communication - Listens and gets clarification; responds well to questions.

Teamwork - Balances team and individual responsibilities; puts success of team above own interests.

Written Communication - Edits work for spelling and grammar.

Team Leadership - Ensures progress toward goals.

Conflict Resolution - Encourages open communications; keeps emotions under control.

Diversity - Promotes a harassment-free environment.

Ethics - Treats people with respect; upholds organizational values.

Organizational Support - Follows policies and procedures; supports organization's goals and values.

Adaptability -Adapts to changes in the work environment; manages competing demands; able to deal with frequent change, delays, or unexpected events.

Personal Appearance - Dresses appropriately for position; keeps self well groomed.

Attendance/Punctuality - Your job is critical for your success, so we need you here, on time, and ready to help!

Dependability - You're our 'go-to' person for analytics and trending and so being able to take direction from key staff while taking responsibility for your own work is imperative to being able to depend on you!

Planning/Organizing - Who doesn't need more of this in their life? We'll need you to be able to prioritizes and plan your own work activities efficiently.

Quality - This is the pinnacle of what we strive for every day. It will be important for you to demonstrate accuracy and thoroughness, whiling monitoring own work to ensure quality.

Safety and Security - We all like to have a good time, but let's be smart about it! This means we ask that you use equipment and materials properly.

Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

At the very least, we need you to have a one-year certificate from college or technical school; and 5 years of related experience and/or training; or equivalent combination of education and experience.

Language Skills

We don't expect a PhD in the English language, but we do want you to have the ability to read and comprehend simple instructions, short correspondence, and memos. This also means you have the ability to write simple correspondence, present information in one-on-one and small group situations to customers, clients, and other employees of the organization.

Reasoning Ability

We're not asking you to be a rocket scientist (it's cool if you are!) but we do want you to have the ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. This looks like having the ability to deal with problems involving a few concrete variables in standardized situations.

Computer Skills

You may or may not have experience with all of these programs, and that is okay, we can train you! However, to perform this job successfully, you will eventually need a decent understanding of Lytec, PrimeSuite, WRS, Office Ally, Practice Mate, PrimeClinical EMR and/or practice management software; Excel Spreadsheet software and Word Processing software.

Certificates, Licenses, Registrations

Super helpful if you have a Medical Billing Certificate and/or a Medical Coding Certificate

Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, you are regularly required to sit and use hands to fingers. You are occasionally required to walk; reach with hands and arms and talk or hear. You must occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.

Work Environment We believe the work environment described above are representative of those our employees encounters while performing their job. Overall, we have a relaxed atmosphere and relatively low noise level, except for the occasionally laugh and tapping of the keyboard!

Keywords: Zymeda Provider Solutions, Moreno Valley , Medical Accounts Receivable Specialist, Other , Moreno Valley, California

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