Collector II

Details

Client Name
Hoag Memorial - Red Hill Clinic

Job Type
Local

Offering
Non-Clinical

Profession
Accountant

Specialty
Hospital

Job ID
14367024

Job Title
Collector II

Weekly Pay
$1080.0


Shift Details

Shift
Day / 7-3

Scheduled Hours
40


Job Order Details

Start Date
05/27/2024

End Date
08/24/2024

Duration
13 Week(s)


Job Description
Collector II

Pride Health is hiring a Medical Collector for one of its clients in California.
This is a 3-month contract with a possible extension with competitive pay and benefits.

Location - Costa Mesa, California- 92626
Pay range - $24 - $28 per hour.
Length of assignment - 3 months (With Possible extension)
Shift - Monday-Friday 1st shift.


Job Summary
The Collector serves as the account representative for the Client in working with insurance companies, government payors, and/or patients for the resolution of payments and accounts resolution.

Job Duties
• 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 Client.
• Reviews and completes payor and/or patient correspondence promptly.
• 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 the 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, and understanding of terms and conditions, as well as Federal and State requirements.
• Interprets Explanation of Bene?ts (EOBs) and Electronic Remittance Advices (ERAs) to ensure proper payment as well as assist and educate patients and colleagues with understanding of bene?t plans.
• Understanding of hospital billing form requirements (UB04) and familiarity 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 e?ectively 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 me payment is due.
• May review for applicable cash rates, special rates, and applicable professional and employee discounts.
• May process bankruptcy and deceased patient accounts.
• Performs other duties as assigned.
• Consistently meets individual productivity and quality assurance standards In addition to the above, the Collector II demonstrates pro?ciency in the functions mentioned above.
• Assists in multiple areas, payors, or departments.
• Assist with special projects and/or additional tasks as needed.
• Able to problem-solve issues as they arise and independently research as needed for resolution.
• Provide support and assist with training of peers as needed.
• Exceeds individual productivity and quality assurance standards for at least 6 consecutive months.
• No corrective action within the last 6 months.

Requirements
• High school diploma or equivalent required.
• Minimum of 50 claims per day doing insurance AR follow-up.
• Minimum of 3 years' experience doing AR follow-up.
• Three years of experience in a hospital/medical and/or related ?eld or strong background in customer service.
• Working knowledge of Epic Resolute, Eric Care, and Epic CPOE.
• Intermediate Excel knowledge is a must.
• Diversity
• Technology & Equipment Skills
• Interpersonal Skills
• Job Knowledge
• Oral/Written Communication
• Travel
• Organizational behavioral Competencies

"Pride Global offers eligible employee's comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto ,home insurance, pet insurance, and employee discounts with preferred vendors. "

Client Details

Address
2995 Red Hill Ave #100, Costa Mesa, CA 92626, United States

City
Costa Mesa

State
CA

Zip Code
92626


Job Board Disclaimer

Equal Employment Opportunity:
Pride-Health is an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.