Healthcare Billing and Collections Specialist

2 weeks ago


Anaheim, California, United States KPC GLOBAL MEDICAL CENTERS INC. Full time
Position Overview

Join Our Esteemed Healthcare Team

KPC GLOBAL MEDICAL CENTERS INC. is on the lookout for a committed professional to take on the role of Healthcare Billing and Collections Specialist. In this vital position, you will be tasked with overseeing account follow-up processes with a variety of third-party payers, including commercial insurance providers, health maintenance organizations (HMOs), preferred provider organizations (PPOs), and other non-governmental entities.

Key Responsibilities:

  • Manage collections, appeals, billing adjustments, and thorough reviews of explanation of benefits (EOBs).
  • Address and resolve all types of claim denials effectively.
  • Offer mentorship and support to new team members, fostering a collaborative environment.
  • Engage in high-priority projects as directed by management.

Qualifications:

  • High School Diploma or equivalent experience.
  • Proven experience in a hospital environment, particularly with managed care contracts and appeals.

Essential Skills:

  • In-depth knowledge of collection strategies and relevant regulations.
  • Familiarity with medical terminology and coding practices.
  • Comprehensive understanding of healthcare networks, including IPAs, HMOs, and PPOs.
  • Ability to work collaboratively within a team and communicate effectively.
  • Persistent, goal-oriented approach to problem-solving.
  • Strong analytical skills with a focus on detail.


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