Collector I

Job Description

Job Description

We are in search of a Collector I to join our team in Costa Mesa, California. As part of our team, your primary function will be to represent our accounts in interactions with insurance companies, government payors, and patients for payment resolution.

You will be responsible for account completion, claim evaluation, and underpayment appeals. Moreover, you will have a strong understanding of the Revenue Cycle processes and thorough knowledge of managed care contracts, current payor rates, and Federal and State requirements.

This role offers a long-term contract employment opportunity.

Responsibilities :

• Serve as the account representative, interacting with insurance companies, government payors, and patients for payment resolution.
• Complete assigned accounts within designated work queues.
• Evaluate claims at the contract rate using the contract management tool for proper pricing.
• Review and initiate the initial appeal for underpayments, observing all timely requirements to secure reimbursement.
• Handle patient and payor correspondence in a timely manner.
• Escalate accounts that need to be appealed due to improper billing, coding, and underpayments.
• Report new / unknown billing edits for review and resolution.
• Understand and apply Revenue Cycle processes, procedures, and policies.
• Have thorough knowledge of managed care contracts, current payor rates, and Federal and State requirements.
• Interpret Explanation of Benefits (EOBs) and Electronic Admittance Advices (ERAs) to ensure proper payment.
• Document all calls and actions taken in the appropriate systems.
• Establish a payment arrangement when patients are unable to pay in full at the time payment is due.
• Demonstrated skills in Customer Service are essential
• Familiarity with various Procedures and Policies
• Proficiency in Payment Processing and Billing Functions
• Experience in Cash Activity management
• Ability to Review documents and processes accurately
• Knowledge of time management, as indicated by 'About Time'
• Understanding of Medical Coverage, Pricing, and Benefit Functions
• Expertise in Billing and Collection Processes
• Excellent written communication skills for Correspondence
• Experience in Claim Administration and Clinical Trial Operations
• Knowledge of Consumer Electronics, Coding, and Authorizations would be beneficial
• Understanding of Methodology, Insurance Companies, Reimbursements, Medicare, and Appeals
• Prior experience in a Patient Account role
• Ability to handle sensitive patient information with discretion and professionalism
• Familiarity with medical terminology and procedures
• Excellent interpersonal and communication skills
• Ability to work independently and as part of a team
• Good organizational skills and attention to detail
• Proficient in the use of computer software and applications relevant to the role
• Ability to manage multiple tasks and prioritize effectively
• High level of integrity and ethics
• Willingness to continually update skills and knowledge as required by the role.
23 days ago