NPH Medi-Cal Collections Representative

University of California - Los Angeles Health; Los Angeles (CA); Presencial; USD 40.000 - 56.000; Jornada completa

Descripción de la vacante

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.

Formación

• 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

Responsabilidades

• 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.

Conocimientos

Analytical skills

Verbal and written communication

Attention to detail

Educación

High school diploma or GED

Herramientas

Excel

Microsoft Word

UB04 knowledge

Descripción del empleo

Patient Business Services

As a Medi-Cal Fee For Service 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: $29.03- $41.23/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 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

Exceptional organizational skills, with the
ability to meet deadlines, work independently or as part of a team, and
prioritize tasks effectively