Manage patient accounts from the point of discharge through billing edits to contract management account net down to final collection of the expected contract amount. Possess and maintain governmental payer knowledgeable of all billing standards and collection requirements. Acts as a collector and perform necessary follow-up to obtain the appropriately owed reimbursement for hospital services. Responsible for all accounts with a contracted insurance as the primary or current payer. Collector will using work lists follow-up with governmental payers to liquidate inventory submitted
Essential Duties:
- Technical knowledge of billing guidelines, contracts and reimbursement methodology, collection follow up for Commercial and Managed Care Government entities. Follow up includes: Completing necessary Provider Disputes/Appeals and Claim Reconsiderations.
- Meets or exceeds monthly quality review.
- Meets or exceeds monthly productivity standards goal. Performs all necessary functions to appropriately perform account follow-ups, appeals and legal referral to liquidate accounts receivable timely.
- Consistently and efficiently utilize payer websites and department reference guides to identify opportunities for improvement and, when appropriate, develop and assist with implementing effective solutions. This includes but not limited to identifying internal and external payor issues.
- Performance and behaviors meets or exceeds expectations, ability to work independently with minimal coaching.
- Processes correspondence within the established timeline of 5 days from receipt
- Knowledge of all contract payers’ rates, system adjudication, and agreements to successfully resolve any underpayments or denials timely.
- Has a clear understanding of the payer matrix of financial responsibility and utilizes this knowledge to do appropriate follow-up on accounts.
- Keeps supervisor informed when problems may interfere with work being completed on time.
- Adapts to changes of unusual circumstances, promotes cooperation and minimizes disruption to working environment.
- Perform other duties as assigned.
Required Qualifications:
- Req 2 years 1-2 years of previous collection experience.
- Req Working knowledge of laws governing collections efforts, insurance and medical terminology, and reimbursement procedures.
- Req Medical services collections and computerized billing systems such as IDX.
Preferred Qualifications:
- Pref High school or equivalent
- Combined education/experience as substitute for minimum experience.
Required Licenses/Certifications:
- Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)
The hourly rate range for this position is $25.00 – $39.69. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.
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