Medical Insurance Specialist $28.00/Hour

3 weeks ago


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

Job description:

  • 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).
  • Has a strong understanding of the Revenue Cycle processes, from Patient Access (authorizations & admissions) through Patient Financial Services (billing & collections), including procedures and policies.
  • 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.
  • Experience collecting from insurance companies is required.

Requirements:

  • High school diploma or equivalent required.


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