Collector and Account Manager

7 days ago

Alhambra, California, United States Keck Medicine of USC Full time
Job Summary

Keck Medicine of USC is seeking a highly skilled Collector and Account Manager to join our team. As a key member of our revenue cycle team, you will be responsible for managing patient accounts from discharge through billing edits to contract management, ensuring timely and accurate collection of expected contract amounts.

Key Responsibilities
  • Manage patient accounts from discharge through billing edits to contract management, ensuring timely and accurate collection of expected contract amounts.
  • Utilize knowledge of governmental payer billing standards and collection requirements to optimize revenue cycle performance.
  • Act as a collector and perform necessary follow-up to obtain owed reimbursement for hospital services.
  • Responsible for all accounts with a contracted insurance as the primary or current payer.
  • Utilize work lists to follow-up with governmental payers to liquidate inventory submitted.
Essential Skills and Qualifications
  • Technical knowledge of billing and collections for Medicare, Medi-Cal, and local Medi-Cal entities.
  • Working knowledge of TARS and SARs processes and follow-up.
  • Ability to perform all necessary functions to appropriately bill and perform account follow-ups, appeals to liquidate accounts payable.
  • Identify opportunities for improvement and develop effective solutions.
  • Actively contact payers by phone or mail when payment is delayed or is an underpaid amount.
  • Handle customer calls and payer inquiries accurately regarding charge inquiries, account status, etc.
  • Process correspondence within the established timeline of 5 days from receipt.
  • Resolve credit balance accounts in a timely manner and resolve underpayment or denial with appropriate action to ensure all accounts are paid per contracted rate.
  • Knowledge of all contract payers, rates, and agreements.
  • Ensure accurate insurance coding is utilized.
  • Properly evaluate reimbursement amounts to ensure maximum payment is being received for all services provided.
  • Able to appeal underpayments when received.
  • Place calls to health plan or look on insurance contracts website to obtain patient eligibility information, update insurance, and/or forward claim to medical group to update.
  • Have a clear understanding of the payer matrix of financial responsibility and utilize this knowledge to do appropriate follow-up on accounts.
  • Enter appropriate documentation online to records activity on patient accounts, including expected reimbursement amounts when calculated manually.
  • Use initiative to resolve problems with appropriate action and follow-through, including documentation when involved in patient/department issues.
  • Identify existing problems in the workflow and utilize resources available to maintain a productive workflow.
  • Accommodate to changes in workload within the department by assisting others.
  • Keep supervisor informed when problems may interfere with work being completed on time.
  • Adapt to changes of unusual circumstances, promote cooperation, and minimize disruption to the working environment.
  • Participate in review, revising, and developing policies and procedures for the department.
Required Qualifications
  • Previous collection experience.
  • Working knowledge of laws governing collections efforts, insurance, and medical terminology, and reimbursement procedures.
  • Medical services collections and computerized billing systems such as IDX.
Preferred Qualifications
  • High school or equivalent.
Required Licenses/Certifications
  • Fire Life Safety Training (LA City) if no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date (Required within LA City only).

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