- Job Title: Medical Collector / Biller
- Job Location: Costa Mesa, CA, 92626
- Department type: REVENUE CYCLE EPIC
- Job Type: Contract
- Shift: 8a-5pm Mon-Friday
Responsibilities:
- -The Collector serves as the account representati ve for Hoag 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 Hoag.
- -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 Admitt ance Advices (ERAs) to ensure proper payment as well asassist 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 ofHMO, 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.
Required Skills & Experience:
- Epic Experience Required
- 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.
Job Type: Contract
Pay: $25.00 - $30.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- Dental insurance
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
Experience:
- Medical insurance: 1 year (Required)
- Epic: 1 year (Required)
- collector: 1 year (Required)
Ability to Commute:
- Costa Mesa, CA (Required)
Work Location: In person