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2 months ago

Los Angeles, California, United States UCLA Health Full time

The Senior Collections Rep (Transplant Financial Counselor) performs all admission functions including in-house financial management as well as provides leadership within his/her functional area. Responsible for verifying accurate demographic and financial information and knowledgeable in the review and interpretation of insurance benefits, performs financial counseling, financial screening, and credit assessment. Establishes all financial arrangements, refers appropriate cases to other agencies, internal and external, to assist patients with discharge/post hospital care. Interacts closely with Utilization Review and Patient Business Services to ensure correct and timely reimbursement.

Salary Range: $30.94-$44.42/hourly

Qualifications

Required:

  • Working knowledge of third party payer verification terminology
  • Working knowledge in the functional operations of third party payors and utilization review agencies to expeditiously coordinate follow-up
  • Working knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, CCS programs, out-of-state Medicaid, or other sponsoring agencies
  • Working knowledge of health plans with special processing requirements for emergency patients and ability to effectively communicate these requirements to physicians and administrative personnel under time urgent conditions.
  • Ability to scrutinize credit reports and evaluate personal financial information to detect any problems, discrepancies or questionable areas and set up an appropriate financial arrangement when necessary (May be trained)
  • Ability to attend to many details within a short span of time
  • Knowledge of the availability of specific accommodations for patients on various nursing units to initiate proper room and care charges (May be trained)
  • Skill in detecting erroneous data input that would otherwise disable census system output mechanism
  • Working knowledge of HMO's and PPO's, in order to understand, explain and calculate Per Diem rates, contractual allowances and percentage discounts.
  • Skill in computing rations, rates and percentages in order to calculate estimated pro-rated balances and patient liability.
  • Skill in analyzing information, problems, situations, practices or procedures in order to define the problem/objective; identify relevant concerns/factors; identify patterns, tendencies or relationships,; formulate logical and objective conclusions; recognize alternatives and their implications

Preferred:

  • Working knowledge of the department functions of an acute care hospital and their organizational interrelationships
  • Knowledge of physician team and specialty to accurately validate medical services rendered to patients
  • Ability to monitor bed availability, predict, and communicate possible problems to appropriate departments