Collector I - Integrated Resources, Inc
Costa Mesa, CA
About the Job
Job Title: Collector I
Location: Costa Mesa, CA- 92626
Duration: 3+ Months (possible extension)
Shift : Mon to fry 8:30 to 5:30
Pay Range: $24 to $26/h on w2
Responsibilities:
Required Skills & Experience:
Location: Costa Mesa, CA- 92626
Duration: 3+ Months (possible extension)
Shift : Mon to fry 8:30 to 5:30
Pay Range: $24 to $26/h on w2
Responsibilities:
- The Collector serves as the account representative for Client 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 Client.
- 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 Benefits (EOBs) and Electronic Admit Advice (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.
- 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 time 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.
Required Skills & Experience:
- One year of previous hospital business experience, or equivalent required or strong background in customer service.
- Basic experience with insurance plans, hospital reimbursement methodology, and/or ICD10 and CPT coding.
- High volume call center setting must have previous experience similar to this must have Home Health Billing experience.
- One year of previous hospital business experience, or equivalent required or strong background in customer service.
- Basic experience with insurance plans, hospital reimbursement methodology, and/or ICD10 and CPT coding.
Source : Integrated Resources, Inc
