Patient Revenue Collector: Accounts & Appeals

Hoag Health System; Costa Mesa (CA); On-site; USD 42,000 - 65,000; Full time

Job summary

Hoag Memorial Hospital Presbyterian is seeking a Collector to serve as the account representative with insurance companies, government payors, and patients to resolve payments and accounts. The role involves completing assigned accounts, maximizing reimbursement, and initiating timely appeals as needed.

You will work within the revenue cycle, from patient access through billing, and use contract management tools to ensure proper pricing and adjudication.

Qualifications

• High school diploma or equivalent required.
• Experience with hospital billing and reimbursement.
• Knowledge of ICD-10 and CPT coding.

Responsibilities

• Serve as the account representative for Hoag with insurance companies, government payors, and/or patients to resolve payments.
• Complete assigned accounts within defined work queues.
• Obtain maximum reimbursement by evaluating claims at contract rate using the contract management tool (e.g., APC, DRG, APRDRG).
• Review and initiate appeals for underpayments in a timely manner to secure reimbursement.
• Correspond with payors and patients promptly regarding billing.
• Escalate issues requiring appeals due to improper billing or underpayments.
• Document all calls and actions in the appropriate systems.

Skills

Revenue cycle knowledge

Insurance payors

EOBs/ERAs interpretation

UB04/HCFA forms knowledge

Customer service

Education

High school diploma or equivalent

Tools

Contract management tool

Patient accounting systems

Job description

Hoag Memorial Hospital Presbyterian is seeking a Collector to serve as the account representative with insurance companies, government payors, and patients to resolve payments and accounts. The role involves completing assigned accounts, maximizing reimbursement, and initiating timely appeals as needed.

You will work within the revenue cycle, from patient access through billing, and use contract management tools to ensure proper pricing and adjudication.