Medi-Cal Collections Specialist – Claims & Payer Liaison

University of California - Los Angeles Health; Los Angeles (CA); Vor Ort; USD 40.000 - 56.000; Vollzeit

Zusammenfassung

University of California - Los Angeles Health's Patient Business Services division seeks a Medi-Cal Fee For Service Collections Representative to manage a designated portfolio of inpatient and outpatient claims, ensuring effective collection efforts and timely reimbursements.

You will conduct regular account reviews, communicate with payers and patients, and apply payer contracts and adjustments to maximize recovery while complying with AB1455, Knox-Keene Act, and health codes.

Qualifikationen

• High school diploma or GED; Minimum of 3 years of relevant experience, including at least 1 year in collections investigation
• Experience in Medi-Cal Fee For Service and Medi-Cal 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

Aufgaben

• 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.

Kenntnisse

Analytical skills

Verbal and written communication

Attention to detail

Ausbildung

High school diploma or GED

Tools

Excel

Microsoft Word

UB04 knowledge

Jobbeschreibung

University of California - Los Angeles Health's Patient Business Services division seeks a Medi-Cal Fee For Service Collections Representative to manage a designated portfolio of inpatient and outpatient claims, ensuring effective collection efforts and timely reimbursements.

You will conduct regular account reviews, communicate with payers and patients, and apply payer contracts and adjustments to maximize recovery while complying with AB1455, Knox-Keene Act, and health codes.