Current jobs related to Collector I - Costa Mesa - Careers Integrated Resources Inc

Job title: Collector I

Location: Costa Mesa, CA

Job Duration: 3 Months +(possible extension)

Pay Range: $30 to $32/h on w2

Job Summary:

· The Collector serves as the account representative for Client 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 to Client.

· Reviews and completes payor and/or patient correspondence in a timely manner.

· 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 direct supervisor for review and resolution.

· Has a strong understanding of the Revenue Cycle processes, from Patient Access (authorizations & 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 Remittance 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 familiar with the HCFA 1500 forms.

· Knowledge of HMO, 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 me payment is due.

· May review for applicable cash rates, special rates, applicable professional and employee discounts.

· May process bankruptcy and deceased patient accounts.

· Performs other duties as assigned.

· Consistently meets individual productivity and quality assurance standards In addition to the above, the Collector II demonstrates proficiency in the functions mentioned above.

· Assists in multiples areas, payors or departments.

· Assist with special projects and/or additional tasks as needed.

· Able to problem solve issues as they arise and independently research as needed for resolution.

· Provides support and assists with training of peers as needed.

· Exceeds individual productivity and quality assurance standards for at least 6 consecutive months.

· No corrective action within the last 6 months.