Medical Collector

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  • 18-00091
  • Full Time/Contract
  • Billing/Collections
  • Los Angeles, CA
Job Description
CLIENT COMPANY OVERVIEW
Our client is a leading Physician Practice Management company responsible for the business services for a leading University Children's Medical Group – the largest pediatric multi-specialty group in the United States and are acclaimed for their leadership in Pediatric and Adolescent health.

POSITION SUMMARY
Medical Collector

The Collector is responsible for maximizing the amount of cash collected and minimizing the time period in which it is collected for each assigned division; for ensuring that the amounts collected on each invoice are correct; for ensuring that accounts receivable age is maintained within specified levels; for ensuring that the appropriate information can be provided to physicians on the status of their accounts receivable; and for providing feedback to managers on clean claim requirements.

ESSENTIAL DUTIES & RESPONSIBILITIES

Medical Collector

  • Monitors accounts receivable for divisions and payment trends.
  • Plans strategies to optimize results for each division/physician.
  • Reviews correspondence and denial information to determine why claims have not been paid; contacts payors accordingly.
  • Fixes and resubmits claims; writes up adjustments and identifies issues that require attention.
  • Monitors success and makes modifications to optimize collections.
  • Provides input to update collection model.
  • Collects revenue on delinquent accounts from parents, guarantors, and third-party payors.
  • Researches and analyzes accounts & payments to determine whether charges were billed properly, and to resolve incorrect information on patient accounts; reverses balance to credit or debit if charges were improperly billed.
  • Contacts insurance companies to resolve payment problems; provides information to expedite the collection process.
  • Sets-up payment arrangements for self-pay accounts; ensures that payments are received according to agreement and follows-up as necessary when payment is not received.
  • Receives and answers inquiries or complaints concerning collection matters; gathers information pertaining to patient accounts for timely resolution of inquiries of complaints.
  • Prepares status of delinquent accounts prior to referring them to the Lead or Manager for further action when collection actions have proved unsuccessful.
  • Sets-up necessary meetings and prepares correspondence to payors regarding the status on their account. Follows-through until a resolution is made on the account.
  • Handle in a professional and confidential manner all correspondence, documentation, and files.
  • Courteous and professional communications with parents and payors.

Medi-Cal Eligibility Denials:

  • Reviews all Medi-Cal and CCS claims prior to mailing to assure that claims contain accurate and complete information; receives all EOBs, analyzes and returns to appropriate individual.
  • Reviews various reports to identify Medi-Cal claims that were denied and analyzes patient accounts to determine their eligibility for appeal.
  • Researches and collects information necessary to support medical charges; determines whether account was incorrectly billed and informs appropriate personnel as to the correct billing procedures.
  • Determines which accounts are appealable and maintains calendar file to assure follow-up activities in order to resolve the account's denied status.
  • Adjusts charges from itemized statements as necessary based upon updated or new information on status of patient accounts.
  • Prepares write-offs of denied claims which cannot be appealed and submits to Lead Account Representative.
  • Completes and maintains journal containing all pertinent information and statistics on denied claims; prepares reports for the Lead Account Representative and Manager.
  • Follows-through on appropriate action to be taken upon the Manager's review.

QUALIFICATIONS / REQUIREMENTS

Knowledge of billing regulations at the federal, state, county, city and private payer levels; organizational policies, procedures, systems and objectives. Knowledge of medical records and health care systems (preferably AthenaNet). Skill in planning and organizing. Ability to justify to payor why high dollar charges should be paid. Skill in exercising initiative, judgment, problem-solving and decision-making. Skill in gathering and analyzing data, and researching, preparing & presenting comprehensive reports. Ability to make sound analytical, billing and collection decisions.

Education and Experience:

  • Associate of Art's degree preferred, high-school and/or equivalent required
  • Three (3) years account follow-up, billing, and collection experience
  • Experience Collecting on physician (Surgical) claims preferred but not required
  • Knowledge of CCS, Medi-Cal and Managed Care billing practices required.
  • Proficiency in AthenaNet highly preferred
  • Ability to work independently.

COMPENSATION
$18.00/hr

POSITION CLASSIFICATION
Full-Time (M-F)
8:00 AM – 4:30 PM

Contract Assignment


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