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NPH Medi-Cal Collections Representative

$29.03 - $41.23 per hour

UCLA Health

Job Title

Medi-Cal Fee For Service Collections Representative

Work Location

Los Angeles, CA, USA

Work Schedule

Monday - Friday, 7:30 AM - 4:30 PM

Salary Range

$29.03 - $41.23 Hourly

Primary Duties and Responsibilities

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.

Job 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
UCLA Health
Vacancy posted 1 hour ago
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