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Position Title: Medical Collector I
Duration:06 Months with possibility of extension
Location: Costa Mesa, CA 92626(Onsite)
Shift hours: Mon – Fri; 08AM to 05 PM.
Pay: $30.00/-Hour
Position Summary:
The Collector serves as the account representative for hospital in working with insurance companies, government payors, and/or patients for resolution of payments and accounts resolution.
Completes assigned accounts within assigned work queues.
Obtains the maximum amount of reimbursement by evaluating claims at the contract rate with the use of the contract management tool for proper pricing (Examples: APC, DRG, APRDRG).
Reviews and initiates the initial appeal for underpayments observing all timely requirements to secure reimbursement due to Hospital.
Reviews and completes payor and/or patient correspondence in a timely manner.
Escalates to the payor and/or patient accounts that need to be appealed due to improper billing, coding and/or underpayments.
Reports new/unknown billing edits to direct supervisor for review and resolution.
Has a strong understanding of the Revenue Cycle processes, from Patient Access (authorizations admissions) through Patient Financial Services (billing & collections), including procedures and policies.
Has thorough knowledge of managed care contracts, current payor rates, understanding of terms and conditions, as well as Federal and State requirements.
Interprets Explanation of Benefits (EOBs) and Electronic Admittance Advice (ERAs) to ensure proper payment as well as assist and educate patients and colleagues with understanding of benefit plans.
Understanding of hospital billing form requirements (UB04) and familiar with the HCFA 1500 forms.
Knowledge of HMO, POS, PPO, EPO, IPA, Medicare Advantage, Covered California (Exchange), capitation, commercial and government payors (i.e. Medicare, Medi-Cal, TriCare, etc) and how these payors process claims.
Demonstrates knowledge of and effectively uses patient accounting systems.
Documents all calls and actions taken in the appropriate systems.
Accurately codes insurance plan codes.
Establishes a payment arrangement when patients are unable to pay in full at the time payment is due.
May review for applicable cash rates, special rates, applicable professional and employee discounts.
May process bankruptcy and deceased patient accounts.
Performs other duties as assigned.
Qualifications:
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.
High school diploma or equivalent required.
Medicare, Cpt coding, Patient accounting, Coding and Customer service
Contractor
$46k-57k (estimate)
07/27/2024
01/21/2025
The job skills required for Medical Collector include Customer Service, Billing, Accounting, Bankruptcy, Managed Care, etc. Having related job skills and expertise will give you an advantage when applying to be a Medical Collector. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Medical Collector. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Medical Collector positions, which can be used as a reference in future career path planning. As a Medical Collector, it can be promoted into senior positions as a Collections Representative III that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Medical Collector. You can explore the career advancement for a Medical Collector below and select your interested title to get hiring information.