Job Information
UCLA Health Hospital Senior Collections Representative - Medi-Cal HMO in Los Angeles, California
Description
The Hospital Senior Collections Representative - Medi-Cal HMO manages a specific portfolio of inpatient and outpatient claims to maximize collection outcomes. Key responsibilities include:
Conducting comprehensive and strategic account reviews.
Leading efforts to resolve reimbursement discrepancies with third-party payers.
Implementing proactive follow-up strategies to expedite account resolution.
Communicate with insurance providers, patients, and internal departments to gather crucial information and address payment challenges promptly and efficiently
Optimize account management efficiency and ensuring timely resolution within the revenue cycle, driving the organization's financial success.
Salary Range: $30.94-$44.42/hourly
Qualifications
We are seeking a self-directed, detail-oriented individual with:
High school diploma or General Education Diploma (GED).
Five or more years of progressive experience in collections, including extensive expertise in complex collections investigations and resolution.
Experience in Medi-Cal HMO Collections, highly desired
Thorough understanding of UB04 requirements and advanced knowledge of medical billing processes, including proficiency in navigating Medicare and Medicaid regulations
Ability to interpret and apply payer contracts, skillfully negotiate payment terms, and successfully process contractual adjustments.
Advanced proficiency in analytical tools and software, particularly Excel/spreadsheets, for detailed data analysis and reporting.
Deep knowledge of collection techniques, laws, and regulations, including AB1455, Knox-Keene Act, Health & Safety Codes, and other relevant statutes
Extensive familiarity with medical terminology, CPT codes, HCPCS codes, and diverse healthcare networks such as IPAs, HMOs, PPOs, PCPs, and contract affiliations
Exceptional verbal and written communication skills, adept at effectively communicating with diverse stakeholders and presenting complex information in a clear and concise manner.
Advanced proficiency in the Microsoft Office suite, specifically Excel and Word
UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.