Collector

Company: Peregrine Team
Location: Costa Mesa
Posted on: May 26, 2023

Job Description:

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 resolution.
• 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 the hospital.
• Reviews and completes payor and/or patient correspondence in a timely manner.
• 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 and policies.
• 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 plans.
• 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 accounting systems.
• Documents all calls and actions taken in the appropriate systems.
• 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