Medi-Cal Collections Representative

University of California - Los Angeles Health; Los Angeles (CA); On-site; USD 38,090 - 54,098; Full time

Job summary

The University of California - Los Angeles Health is seeking a Medi-Cal Collections Representative to manage a portfolio of inpatient and outpatient claims, ensuring effective collection efforts and timely resolutions.

You will review accounts, liaise with third‑party payers to resolve discrepancies, follow up on claims, and coordinate with insurers, patients and internal teams to secure payment.

Qualifications

• High school diploma or GED with 3+ years in collections
• At least 1 year in collections investigation
• Experience with commercial and managed care collections preferred

Responsibilities

• Conduct regular account reviews to identify outstanding balances
• Initiate and maintain communication with third-party payers to resolve reimbursement discrepancies
• Diligently follow up on claims to ensure timely resolution
• Communicate with insurance providers, patients, and internal departments to gather necessary information and resolve payment issues

Skills

Excel

Analytical skills

Communication skills

Organizational skills

Independent worker

Team collaboration

Education

High school diploma or GED

Tools

UB04 knowledge

Microsoft Office

Job description

Description

As a Medi-Cal Collections Representative, you will manage a designated portfolio of inpatient and outpatient claims, ensuring effective and efficient collection efforts. Your primary responsibilities include:

• Conducting regular account reviews to identify outstanding balances.
• Initiating and maintaining communication with third-party payers to resolve reimbursement discrepancies.
• Diligently following up on claims to ensure timely resolution.
• Communicate with insurance providers, patients, and internal departments to gather necessary information and resolve payment issues.

Salary Range: $27.65- $39.27/hourly

Qualifications

We are seeking a self-directed, detail-oriented individual with:

• High school diploma or GED; Minimum of 3 years of relevant experience, including at least 1 year in collections investigation.
• Experience in commercial and managed care collections, highly desired.
• Ability to interpret payer contracts and process contractual adjustments.
• In-depth knowledge of UB04 requirements and medical billing processes.
• Strong analytical skills and proven proficiency in Excel and spreadsheets.
• Understanding of collection techniques and laws, including AB1455, the Knox-Keene Act, Health & Safety Codes, etc., familiarity with medical terminology, CPT codes, HCPCS codes, health networks, IPAs, HMOs, PPOs, PCPs, and contract affiliations.
• Excellent verbal and written communication skills.
• Proficiency in Microsoft Office, especially Excel and Word.
• Exceptional organizational skills, with the ability to meet deadlines, work independently or as part of a team, and prioritize tasks effectively.