Medical Billing & Collections: Appeals & Credits

Keck Medicine of USC; Pasadena (CA); On-site; USD 36,000 - 56,000; Full time

Job summary

Keck Medicine of USC in Pasadena, California is seeking a Collector Appeal Specialist to process inpatient and outpatient claims to third party payers and private pays, ensuring timely filing and strict adherence to guidelines. The role includes appeals, denial management, and quality reviews within Cerner and other systems.

Responsibilities involve follow-up on insurance claims, documentation of activities, and collaboration with the billing team to optimize cash flow while maintaining patient

Qualifications

• High school diploma or equivalent required; experience in medical billing and collections preferred.
• Experience with medical services collections across Medicare, Medi-Cal, HMO/PPO, and private pay is required.
• Strong knowledge of medical terminology and reimbursement procedures; ability to interpret Explanation of Benefits.

Responsibilities

• Process inpatient and outpatient claims to third party payers and private pays following billing guidelines.
• Perform follow-up on accounts, arrange payment plans, and request rebills as needed.
• Prepare and submit appeals and correspondence for denials and complex billing issues.
• Maintain confidentiality and adhere to HIPAA regulations while handling patient information.
• Document activities in the billing system and communicate issues to supervisors.

Skills

Medical collections

Excellent communication

Billing systems knowledge

Medical terminology

Problem resolution

Tools

IDX

Cerner

GE Centricity

MARS Refunds App

ETM

Job description

Keck Medicine of USC in Pasadena, California is seeking a Collector Appeal Specialist to process inpatient and outpatient claims to third party payers and private pays, ensuring timely filing and strict adherence to guidelines. The role includes appeals, denial management, and quality reviews within Cerner and other systems.

Responsibilities involve follow-up on insurance claims, documentation of activities, and collaboration with the billing team to optimize cash flow while maintaining patient