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Job Saved Save Job

Hospital Senior Collections Representative - Medi-Cal HMO

UCLA

Details

Posted: 08-Sep-24

Location: Los Angeles, California

Salary: Open

Categories:

Admin / Clerical

Internal Number: 142197727

Description

The Hospital Senior Collections Representative - Medi-Cal HMO manages a specific portfolio of inpatient and outpatient claims to maximize collection outcomes. Key responsibilities include:

Conducting comprehensive and strategic account reviews.
Leading efforts to resolve reimbursement discrepancies with third-party payers.
Implementing proactive follow-up strategies to expedite account resolution.
Communicate with insurance providers, patients, and internal departments to gather crucial information and address payment challenges promptly and efficiently
Optimize account management efficiency and ensuring timely resolution within the revenue cycle, driving the organization's financial success.

Salary Range: $32.24 - $46.29/hourly

Qualifications

We are seeking a self-directed, detail-oriented individual with:

High school diploma or General Education Diploma (GED).
Five or more years of progressive experience in collections, including extensive expertise in complex collections investigations and resolution.
Experience in Medi-Cal HMO Collections, highly desired
Thorough understanding of UB04 requirements and advanced knowledge of medical billing processes, including proficiency in navigating Medicare and Medicaid regulations
Ability to interpret and apply payer contracts, skillfully negotiate payment terms, and successfully process contractual adjustments.
Advanced proficiency in analytical tools and software, particularly Excel/spreadsheets, for detailed data analysis and reporting.
Deep knowledge of collection techniques, laws, and regulations, including AB1455, Knox-Keene Act, Health & Safety Codes, and other relevant statutes
Extensive familiarity with medical terminology, CPT codes, HCPCS codes, and diverse healthcare networks such as IPAs, HMOs, PPOs, PCPs, and contract affiliations
Exceptional verbal and written communication skills, adept at effectively communicating with diverse stakeholders and presenting complex information in a clear and concise manner.
Advanced proficiency in the Microsoft Office suite, specifically Excel and Word

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About UCLA

At UCLA Health, you can help heal humankind, one patient at a time by improving health, alleviating suffering and delivering acts of kindness. As you do, you’ll achieve great things in your life and your career. We’re a world-class health organization with four hospitals consistently recognized among the nation’s very best as well as an internationally-renowned medical school, primary and specialty care clinics and much more. Within our dynamic, innovative and growing organization, you’ll find exceptional opportunities to make the most of your abilities in a supportive, empowering and inclusive environment. If you embrace our values of Integrity, Compassion, Respect, Teamwork, Excellence and Discovery we invite you to see all you can accomplish at UCLA Health.

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