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Patient Account Assistant

Mercy Healthcare Rancho Cordova, California
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The posted compensation range of $24.00 - $32.91 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.

Requisition ID 2025-421319 Employment Type Full Time Department Claims Processing Hours/Pay Period 80 Shift Day Weekly Schedule 7:30 am - 4 pm Remote No Category Accounting and Finance

Responsibilities
This position is responsible for administering complex payable functions as related to Medicare risk contracts, commercial capitation. This position is also expected to calculate and submit reinsurance claims by merging multiple systems data downloads into spreadsheets and employing complex pricing methodology to value all internal and external capitated claims on an as needed basis. This position will be responsible to pull queries and reports from claims databases for Managed Care Contracting, General Ledger and other management as needed.
  • Prepare monthly and quarterly compliance reports for claims timeliness and provider disputes accurately 
  • Verify authorization in IDX, with health care provider, complete benefit determination, process complex claims with manual calculations using current National Drug Codes and Average Wholesale Pricing in IDX system
  • Report any non-compliant issues with regards to C.I.A. guidelines to management prior to processing

Qualifications

Required: 

  • Three years of clerical experience in medical claims adjudication Equivalent combination of education and experience

Preferred:

  • Applied science in medical billing and claims adjudication or equivalent
Overview

Dignity Health, one of the nation’s largest health care systems, is a 22-state network of more than 9,000 physicians, 63,000 employees, and 400 care centers, including hospitals, urgent and occupational care, imaging and surgery centers, home health, and primary care clinics. Headquartered in San Francisco, Dignity Health is dedicated to providing compassionate, high-quality, and affordable patient-centered care with special attention to the poor and underserved. For more information, please visit our website at www.dignityhealth.org. You can also follow us on Twitter and Facebook.

One Community. One Mission. One California 

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Equal Opportunity

CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here.

CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.