Title - Collector I

Schedule: Monday - Friday 7:00am – 8:30 am and end 3:30 pm – 5:00pm

Pay: $26/hr

Onsite in Costa Mesa, CA

MUST BE VACCINATED

• Serve as the account representative for well-known hospital, interacting with insurance companies, government payors, and patients to resolve payment and account issues.
• Complete assigned accounts within designated work queues.
• Maximize reimbursement by evaluating claims at contract rates using contract management tools (e.g., APC, DRG, APRDRG).
• Initiate initial appeals for underpayments, ensuring adherence to timely requirements for reimbursement.
• Review and handle payor and patient correspondence in a timely manner.
• Escalate accounts that need appeals due to improper billing, coding, or underpayments.
• Report new billing edits to supervisors for review and resolution.
• Demonstrate a strong understanding of Revenue Cycle processes, including Patient Access and Patient Financial Services (billing & collections), as well as procedures and policies.
• Possess thorough knowledge of managed care contracts, current payor rates, and understanding of terms, conditions, Federal, and State requirements.
• Interpret Explanation of Benefits (EOBs) and Electronic Admittance Advices (ERAs) to ensure proper payment and assist patients and colleagues in understanding benefit plans.
• Understand hospital billing form requirements (UB04) and be familiar with HCFA 1500 forms.
• Have knowledge of various payors (HMO, POS, PPO, EPO, IPA, Medicare Advantage, Covered California, capitation, commercial, and government payors) and their claims processing procedures.
• Demonstrate knowledge of and effectively use patient accounting systems.
• Document all calls and actions taken in appropriate systems.
• Accurately code insurance plan codes.
• Establish payment arrangements when patients are unable to pay in full at the time payment is due.
• Review applicable cash rates, special rates, applicable professional and employee discounts.
• Process bankruptcy and deceased patient accounts.