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Medi-Cal Collections Representative

Medi-Cal Collections Representative

University of CaliforniaLos Angeles, CA, United States
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Description As a Medi-Cal 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.

Salary Range : $26.79 - $38.05 / hourly 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 commercial and 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
  • Exceptional organizational skills, with the ability to meet deadlines, work independently or as part of a team, and prioritize tasks effectively
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    Collection Representative • Los Angeles, CA, United States

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