Company: Peregrine Team
Location: Costa Mesa
Posted on: May 26, 2023
Peregrine Team is hiring for a Collector -in Costa Mesa, CA.
This position is a full-time, contract to hire role with full
benefits and competitive pay. - - -$23-30/hr depending on
experience -Job Duties: -
- The Collector serves as the account representative for the
hospital in working with insurance companies, government payors,
and/or patients for resolution of payments and accounts
- Completes assigned accounts within assigned work queues.
- Obtains the maximum amount of reimbursement by -evaluating
claims at the contract rate with the use of the contract management
tool for proper pricing (Examples: APC, DRG, APRDRG).
- Reviews and initiates the initial appeal for underpayments
observing all timely requirements to secure reimbursement due to
- Reviews and completes payor and/or patient correspondence in a
- Escalates to the payor and/or patient accounts that need to be
appealed due to improper billing, coding and/or underpayments.
- Reports new/unknown billing edits to direct supervisor for
review and resolution.
- Has a strong understanding of the Revenue Cycle processes, from
Patient Access (authorizations admissions) through Patient
Financial Services (billing & collections), including procedures
- Has thorough knowledge of managed care contracts, current payor
rates, understanding of terms and conditions, as well as Federal
and State requirements.
- Interprets Explanation of Benefits (EOBs) and Electronic Admitt
ance Advices (ERAs) to ensure proper payment as well asassist and
educate patients and colleagues with understanding of benefit
- Understanding of hospital billing form requirements (UB04) and
familiar with the HCFA 1500 forms. Knowledge of HMO, POS, PPO, EPO,
IPA, Medicare Advantage, Covered California (Exchange), -
capitation,commercial and government payors (i.e. Medicare,
Medi-Cal, TriCare, etc) and how these payors process claims.
- Demonstrates knowledge of and effectively uses patient
- Documents all calls and actions taken in the appropriate
- Accurately codes insurance plan codes.
- Establishes a payment arrangement when patients are unable to
pay in full at the time payment is due.
- May review for applicable cash rates, special rates, applicable
professional and employee discounts.
- May process bankruptcy and deceased patient accounts. Performs
other duties as assigned.Qualifications: -
- One year of previous hospital business experience, or
equivalent required or strong background in customer service.
- Basic experience with insurance plans, hospital reimbursement
methodology, and/or ICD10 and CPT coding.
- High school diploma or equivalent required.
- Shift: -40 hours- 5x8 - -Email your resume to ASAP or apply
here for consideration. -Powered by JazzHR
Keywords: Peregrine Team, Costa Mesa , Collector, Other , Costa Mesa, California
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