Collections Specialist Hospital - Business Office - Full Time - Days - 8hr

Job Summary

Performs account follow up from third-party payers including traditional commercial insurance carriers, Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), EPO's, International Payers, Auto Liability and other Liability carriers, and all other non-governmental third-party payers. Duties include collections, appeals, billing, adjustments, EOB review, correspondence and managing all types of denials. Works on special complex high priority projects as assigned by management.

Job Requirements

• Minimum Education Requirement : High School diploma or equivalent, or work experience in lieu of High School Diploma. Bilingual Spanish preferred.
• Minimum Experience Requirement : Three years' billing experience is preferred. Experience within an acute hospital setting, with strong emphasis on managed care contract and appeals/underpayment collection activities. Excellent customer service skills. Knowledge of collection techniques and collection laws (i.e. AB1455, Knox-Keene Act, Health & Safety Codes, etc.). Knowledge of medical terminology and CTP/HCPS codes. Knowledge of networks, IPA's, HMO's, PPO's and PCP's and contract affiliations. Strong analytical skills, proficient with spreadsheets.
• Minimum License Requirement : None.

Qualifications

• Strong analytical skills, proficient with spreadsheets.

Skills

• Collection techniques and collection laws (i.e. AB1455, Knox-Keene Act, Health & Safety Codes, etc.)
• Medical terminology and CTP/HCPS codes
• Knowledge of networks, IPA's, HMO's, PPO's and PCP's and contract affiliations

Benefits

Delivering world-class health care one patient at a time.