Patient Accounting Collector: Reimbursement Specialist

Hoag Hospital Irvine; Costa Mesa (CA); Hybrid; USD 42,000 - 54,000; Full time

Job summary

Hoag Memorial Hospital Presbyterian in California is seeking an Accounts Collector to manage payments with insurance companies, government payors, and patients. The role involves resolving accounts, maximizing reimbursement, and handling appeals for underpayments within Hoag’s Revenue Cycle framework.

Ideal candidates have a background in hospital business operations, knowledge of insurance plans, and familiarity with ICD10 and CPT coding, ensuring timely and accurate communications and

Qualifications

• High school diploma or equivalent required.
• One year of previous hospital business experience, or equivalent required or strong background in customer service.
• Basic experience with insurance plans, hospital reimbursement methodology, and/or ICD10 and CPT coding.

Responsibilities

• Acts as account representative for Hoag with insurance companies, government payors, and/or patients for resolution of payments and accounts.
• Completes assigned accounts within assigned work queues.
• Obtains maximum reimbursement by evaluating claims at contract rate with contract management tools (APC, DRG, APRDRG).
• Reviews and initiates initial appeals for underpayments to secure reimbursement.
• Reviews and completes payor/patient correspondence in a timely manner.
• Escalates to payor/patient accounts that need to be appealed due to improper billing or underpayments.
• Reports new/unknown billing edits to supervisor for review and resolution.
• Demonstrates knowledge of Revenue Cycle processes from Patient Access through Patient Financial Services.

Skills

Revenue Cycle knowledge

Billing & Coding

Customer service

Communication skills

Job description

Hoag Memorial Hospital Presbyterian in California is seeking an Accounts Collector to manage payments with insurance companies, government payors, and patients. The role involves resolving accounts, maximizing reimbursement, and handling appeals for underpayments within Hoag’s Revenue Cycle framework.

Ideal candidates have a background in hospital business operations, knowledge of insurance plans, and familiarity with ICD10 and CPT coding, ensuring timely and accurate communications and