Collector II for Local Hospital $28.00/Hour

4 weeks ago

Costa Mesa, United States HELP-Hire Healthcare Full time
Job DescriptionJob Description

Job Description Summary:

  • The Collector serves as the account representative for Hoag in working with insurance companies, government payors, and/or patients for resolution of payments and accounts resolution. 
  • 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). 
  • 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. 
  • 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. 

Skills:

  • 3 years of experience in a hospital/medical and/or related field or strong background in customer service.
  • 3 years’ experience doing AR follow up.
  • Working knowledge of Epic Resolute, Eric Care, and Epic CPOE.
  • Intermediate Excel knowledge is a must.

Requirements:

  • High school diploma or equivalent required.

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