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General Information

Work Location: Los Angeles, USA
Onsite or Remote
Flexible Hybrid
Work Schedule
Monday - Friday; 7:00 AM - 4:00 PM
Posted Date
11/01/2024
Employment Type
2 - Staff: Career
Duration
Indefinite
Job #
20304

Primary Duties and Responsibilities

As a Medi-Cal Collections Representative, you will manage a designated portfolio of inpatient and outpatient claims, ensuring effective and efficient collection efforts. Your primary responsibilities include:
  • Conducting regular account reviews to identify outstanding balances.
  • Initiating and maintaining communication with third-party payers to resolve reimbursement discrepancies.
  • Diligently following up on claims to ensure timely resolution.
  • Communicate with insurance providers, patients, and internal departments to gather necessary information and resolve payment issues.
Salary Range: $26.79 - $38.05/hourly

Job Qualifications

We are seeking a self-directed, detail-oriented individual with:
  • High school diploma or GED; Minimum of 3 years of relevant experience, including at least 1 year in collections investigation
  • Experience in commercial and managed care collections, highly desired
  • Ability to interpret payer contracts and process contractual adjustments
  • In-depth knowledge of UB04 requirements and medical billing processes
  • Strong analytical skills and proven proficiency in Excel and spreadsheets
  • Understanding of collection techniques and laws, including AB1455, the Knox-Keene Act, Health & Safety Codes, etc., Familiarity with medical terminology, CPT codes, HCPCS codes, health networks, IPAs, HMOs, PPOs, PCPs, and contract affiliations
  • Excellent verbal and written communication skills
  • Proficiency in Microsoft Office, especially Excel and Word
  • Exceptional organizational skills, with the ability to meet deadlines, work independently or as part of a team, and prioritize tasks effectively

As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.