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GOVT AND NON GOVT COLLECTOR - BUSINESS SERVICE-MANAGED CARE

Department:  Business Services
Status:  Full Time
Shift:  1st

Primary Duties and Responsibilities

The Govt & Non-Government Collector is responsible for the management of patient accounts from the point of admission to reimbursement from the payor. This position is specific to Government Payors-Medicare and MediCal. This role works as a representative for Hoag in working with patients, internal departments, external business partners (IPA’s, provider relations, government payors and insurance companies) and clinical departments to obtain the maximum reimbursement for hospital services. Applies knowledge of vast array of government payors and insurances companies to complete assigned accounts from collection work-list, initiates appeals for underpayments, and conducts audits of accounts for billing and regulatory requirements. Identifies charge capture and missing charges, recommends denial edits, and escalates payor accounts that need to be appealed due to improper billing, coding and/or underpayments. Interprets Explanation of Benefits (EOB) and Electronic Admittance Advices (ERAs) to ensure proper payments and educate patients. Performs other duties as assigned.

 

Education and Experience

Required:

 

High school diploma or equivalent with 1-2 years of billing and/or collection experience

 

Preferred:

 

Basic understanding of ICD10, CPT coding and medical terminology

 

Basic skills in Microsoft Office (Word/Excel)

 

 

 

 


Nearest Major Market: Orange County
Nearest Secondary Market: Los Angeles

Job Segment: Medical, Service Manager, Law, Medicare, Collections, Healthcare, Customer Service, Legal, Finance

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