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Medical Collector

1 month ago

Costa Mesa, United States Global HIT Full time

Our esteemed hospital client is looking for a **Medical Collector II **to support their medical Office in **Costa Mesa, CA. **for **a 3+month contract**

**Address**: 2995 Red Hill Ave Costa Mesa, CA. 100% ONSITE.

**Notes**:
100% onsite. Minimum of 50 claims per day doing insurance AR follow up -Certifications needed? High School Diploma and minimum of 3 years’ experience doing AR follow up

**Duties**:
Job Summary:
The Collector serves as the account representative for hospital 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 hospital.
- 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 Bene?ts (EOBs) and Electronic Remittance Advices (ERAs) to ensure proper payment as well as assist and educate patients and colleagues with understanding of bene?t 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 profciency 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.

**Skills**:
Required Skills & Experience:

- Three years of experience in a hospital/medical and/or related or strong background in customer service.
- Working knowledge of Epic Resolute, Eric Care, and Epic CPOE.
- Intermediate Excel knowledge is a must.
- Diversity
- Technology & Equipment Skills
- Interpersonal Skills
- Job Knowledge
- Oral/Written Communication
- Travel
- Organization Behavioral Competencies
- BUSINESS ACUMEN
- CUSTOMER SATISFACTION
- INNOVATION
- TRUST & ACCOUNTABILITY

**Education**:
Required Education:

- High school diploma or equivalent required.

**Job Types**: Full-time, Contract

Pay: $19.00 - $23.00 per hour

**Benefits**:

- 401(k)
- Dental insurance
- Flexible schedule
- Health insurance
- Vision insurance

Schedule:

- 8 hour shift
- Day shift
- Monday to Friday

Work setting:

- Office

**Education**:

- High school or equivalent (required)

**Experience**:

- Epic EMR: 3 years (required)
- Medical A/R: 3 years (required)
- Medical Collections: 3 years (required)
- Healthcare insurasnce payors: 3 years (required)

Ability to Commute:

- Costa Mesa, CA 92626 (required)

Work Location: In person

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