Job Title:Collector I
Location:995 Red Hill Avenue, Costa Mesa, CA 92626
Duration:3+ months contract
Work Schedule:7:00 am to 3:30 PM PST
 
Position Summary: 
-The Collector serves as the account representative 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 Hoag. -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 ofHMO, 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.
 
Required Skills & Experience: 
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.
EPIC Hyperspace experience is required.

Education Required: 
High School Diploma