Medical Collector | Costa Mesa, CA

Detailed Information

  • Location: Costa Mesa, CA

  • Company: Careerbuilder-US

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.

Requirements: -Must have high volume medical collections experience, and experience using EPIC. -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. Note: This job description is intended to provide a general overview of the position. Other duties may be assigned as needed.

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