Job Title: Managed Care Collector
Hours: Monday - Friday (8:30am - 5pm)
Address: (Please include Zipcode)
Los Angeles, California 90048
Overview of Responsibilities (Describe a typical day, metrics/quota)
Improves revenue cycle capture accuracy as a result of analyzing CSMC Managed Care Contracts and reconciling to payments received; successfully collecting underpayments from insurance carriers; accurately and consistently documenting the results of all audits and subsequent payments in the hospital information system; submits appeals; preparing reports as required by management regarding audit results, process improvement recommendations and systemic payment errors, and providing monthly observations and recommendations to prevent future cash losses from managed care payment variances.
They need strong managed care and commercial insurance experience (PPO/HMO). Non-government (another team handles Medi-Cal HMO and Medicare HMO).
Five + years hospital billing and collections experience. She is pretty strict on this
Epic (CS-Link) Trained- HIGHLY PREFERRED
Computer literacy, interaction and keying skills; full competency MS Office
Ability to interact with, understand and update patient accounting applications used to manage patient accounts.
Verbal and written communication to handle inquiries from patients, patient representatives or insurance companies.
Detail and problem-solving aptitude.
Knowledge of basic accounting principles and healthcare billing and collections practices.
Knowledge and understanding of CSHS policies and procedures governing credit balances and resolution of CSHS provider contracts with insurance companies
Ability to interpret and discuss insurance explanations of benefits and payments.
Ability to meet production and quality expectations on a weekly/monthly basis.
Ability to perform complex mathematical calculations.
Ability to use correct forms, codes to process and document work.
Demonstrated ability to prioritize and organize work and complete assignments in a timely and accurate manner.
Ability to function effectively and productively under conflicting demand on time and attention.
Ability to assist management with special projects.
Ability to assist staff with concerns and issues in the event that management is unavailable.
Training: There is about 2-3 weeks of training! One week involves just system training and an AC collector course as well as hands on
Metrics: Working 40-50 accounts daily
5+ years of managed care experience
Experience working with all commercial payors, NO GOVERNMENT for this role
EPIC highly preferred
Understand and analyze contracts
Experience working high dollar accounts
Resource- can jump in a roll and get rockin and rollin
Attention to detail!