Job Overview:
We are seeking a detail-oriented Collector to join our team. The role involves managing accounts receivable and ensuring timely payments from customers. The ideal candidate should have a background in telemarketing, customer service, and accounts receivable.
Duties:
--The Collector serves as the account representative in working with insurance companies,government payors, and/or patients for resolution of payments and accounts resolution.
-Completes assigned accounts within assigned work queues.
-Obtains the maximum amount of reimbursement by evaluating claims at the contract rate with the use of the contract management tool for proper pricing (Examples: APC, DRG, APRDRG).
-Reviews and initiates the initial appeal for underpayments observing all timely requirements to secure reimbursement due.
-Reviews and completes payor and/or patient correspondence promptly.
-Escalates to the payor and/or patient accounts that need to be appealed due to improper billing, coding and/or underpayments.
-Reports new/unknown billing edits to the direct supervisor for review and resolution.
-Has a strong understanding of the Revenue Cycle processes, from Patient Access (authorization admissions) through Patient Financial Services (billing & collections), including procedures and policies.
-Has thorough knowledge of managed care contracts, current payor rates, understanding of terms and conditions, as well as Federal and State requirements.
-Interprets Explanation of Benefits (EOBs) and Electronic Admittance Advices (ERAs) to ensure proper payment as well as assist and educate patients and colleagues with understanding of benefit plans.
-Understanding of hospital billing form requirements (UB04) and familiarity with the HCFA 1500 forms.
-Knowledge ofHMO, POS, PPO, EPO, IPA, Medicare Advantage, Covered California (Exchange), capitation,commercial and government payors (i.e. Medicare, Medi-Cal, Tricare, etc) and how these payors process claims.
-Demonstrates knowledge of and effectively uses patient accounting systems.
-Documents all calls and actions taken in the appropriate systems.
-Accurately codes insurance plan codes.
-Establishes a payment arrangement when patients are unable to pay in full at the time payment is due.
-May review for applicable cash rates, special rates, and applicable professional and employee discounts.
-May process bankruptcy and deceased patient accounts.
-Performs other duties as assigned.
Qualifications:
-One year of previous hospital business experience, or equivalent required or strong background in customer service.
-Basic experience with insurance plans, hospital reimbursement methodology, and/or ICD10 and CPT coding.
-High school diploma or equivalent required.
Join our team as a Collector and contribute to maintaining positive customer relationships while ensuring timely payments are received.
Job Types: Full-time, Contract
Pay: $25.00 - $28.00 per hour
Expected hours: 40 per week
Benefits:
Weekly day range:
- Monday to Friday
- No weekends
Work setting:
Experience:
- Customer service: 1 year (Required)
- Medical collection: 1 year (Required)
- Epic: 1 year (Required)
- ICD-10: 1 year (Required)
- CPT coding: 1 year (Required)
- Hospital settings: 1 year (Required)
Ability to Commute:
- Costa Mesa, CA (Required)
Ability to Relocate:
- Costa Mesa, CA: Relocate before starting work (Required)
Work Location: In person