Collector II: Revenue Cycle Operations
Primary Duties and Responsibilities
- Completes assigned accounts within assigned work queues.
- Evaluates claims at the contract rate using the contract management tool for proper pricing (Examples: APC, DRG, APRDRG).
- 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 accounts needing appeals due to improper billing, coding, and/or underpayments to the payor and/or patient.
- Reports new/unknown billing edits to direct supervisor for review and resolution.
- Has a strong understanding of the Revenue Cycle processes, from Patient Access to Patient Financial Services.
- Interprets Explanation of Benefits (EOBs) and Electronic Admittance Advices (ERAs) to ensure proper payment and assist patients and colleagues with understanding of benefit plans.
- Documents all calls and actions taken in the appropriate systems.
- Accurately codes insurance plan codes.
- Establishes payment arrangements for patients unable to pay in full at the time payment is due.
- Processes applicable cash rates, special rates, professional and employee discounts, bankruptcy, and deceased patient accounts.
- Performs other duties as assigned.
- Maintains individual productivity and quality assurance standards.
About the Role
Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers, and a network of more than 1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year. For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County’s health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit, and philanthropy. Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes. Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News & World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California.
Qualifications
- High school diploma or equivalent required.
- Three years of experience in a hospital/medical and/or related field or strong background in customer service.
- Intermediate Excel knowledge is a must.
- No certifications required.
About Us
Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers, and a network of more than 1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year. For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County’s health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit, and philanthropy. Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes. Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News & World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California.