Medi-Cal Collections Representative

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

Job summary

A leading healthcare provider in Los Angeles is seeking a Medi-Cal Collections Representative to manage claims and ensure effective collection efforts. The ideal candidate will have a strong background in collections, excellent analytical skills, and relevant experience. Responsibilities include conducting account reviews, communicating with payers, and resolving discrepancies. This role offers a competitive salary range of $27.65 to $39.27 per hour.

Qualifications

• Minimum of 3 years of relevant experience, including at least 1 year in collections investigation.
• Experience in commercial and managed care collections is highly desired.
• Ability to interpret payer contracts and process adjustments.

Responsibilities

• Manage a portfolio of inpatient and outpatient claims.
• Conduct regular account reviews to identify outstanding balances.
• Initiate communication with third-party payers to resolve discrepancies.

Skills

Detail-oriented

Analytical skills

Communication skills

Organizational skills

Education

High school diploma or GED

Tools

Microsoft Excel

Microsoft Word

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

UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.