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Medicare Collections Representative
UCLA
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Details

Posted: 03-Mar-25

Location: Los Angeles, California

Categories:

Admin / Clerical

Internal Number: 146489752

Description

As a Medicare 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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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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