Non-Government Collector - Patient Accounting - Full Time 8 Hour Days (Non-Exempt) (Non-Union)

Keck Hospital of USC, a 343-bed acute care hospital, provides exceptional and innovative care for complex medical and surgical conditions across a wide range of specialties. The hospital’s world-renowned physicians deliver compassionate, customized, patient-centered care and treat the most acutely ill patients with highly innovative techniques and treatment plans. As a leading academic medical center, hundreds of clinical trials are currently taking place at Keck Hospital and its affiliated research institutions, giving patients access to novel and promising therapies that are generally not available elsewhere.

About the role

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 knowledge of all billing standards and collection requirements. Act 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.

Responsibilities

• Technical knowledge of billing and collections for Medicare, Medi-Cal, local Medi-Cal entities. Continually keep abreast of changes that impact billing and collections.
• Working knowledge of TARS and SARs processes and follow-up.
• Perform all necessary functions to appropriately bill, perform account follow-ups, and appeals to liquidate accounts payable.
• Identify opportunities for improvement and, when appropriate, develop and implement effective solutions.
• Actively contact payers by phone or mail when payment is delayed or is an underpaid amount.
• Handle all customer calls and payer inquiries accurately regarding charge inquiries, account status, etc.
• Process correspondence within the established timeline of 5 days from receipt.
• Resolve credit balance accounts in a timely manner.
• Resolve any underpayment or denial with appropriate action to ensure all accounts are paid per contracted rate.
• Knowledge of all contract payers, rates, and agreements. Ensure accurate insurance coding is utilized.
• Properly evaluate reimbursement amounts to ensure maximum payment is being received for all services provided. Appeal when underpayments are received.
• Place calls to health plans or look on insurance contracts website to obtain patient eligibility information, update insurance, and/or forward claims to medical group to update.
• Have a clear understanding of the payer matrix of financial responsibility and utilize this knowledge to do appropriate follow-up on accounts.
• Enter appropriate documentation online to record activity on patient accounts, including expected reimbursement amounts when calculated manually.
• Use initiative to resolve problems with appropriate action and follow-through, including documentation when involved in patient/department issues.
• Identify existing problems in the workflow and utilize resources available to maintain a productive workflow.
• Accommodate changes in workload within the department by assisting others.
• Keep supervisor informed when problems may interfere with work being completed on time.
• Adapt to changes in unusual circumstances, promote cooperation, and minimize disruption to the working environment.
• Participate in review, revising, and developing policies and procedures for the department.
• Perform other duties as assigned.

Requirements

• High School diploma or equivalent.
• Previous collection experience.
• Working knowledge of laws governing collections efforts, insurance and medical terminology, and reimbursement procedures.
• Medical services collections and computerized billing systems such as IDX.
• 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).

Pay

The hourly rate range for this position is $26.00 - $41.28. 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.