Sr Collections Rep - PB Financial Services - FT Days

UCI Health is one of California’s largest academic health systems and the clinical enterprise of the University of California, Irvine. Established in 1976, UCI Health has grown into a 1,461-bed system that includes UCI Health — Orange, UCI Health — Irvine, four Community Network hospitals, and a network of ambulatory care centers across Orange and Los Angeles counties. As Orange County’s only academic health system, UCI Health is home to the county’s only National Cancer Institute-designated comprehensive cancer center, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center, a Gold Level 1 Geriatric Emergency Department, and a nationally recognized regional burn center. Powered by UC Irvine, UCI Health serves 5.6 million people through excellence in patient care, research, and medical education.

About the Role

The Sr./Lead Collections Representative is an advanced-level role demonstrating competency in all duties typically performed by a Collections Representative. This position functions with limited supervision, independently managing and resolving complex, high-level accounts and transactions in a timely manner. It involves taking appropriate billing, collections, or customer service actions to resolve accounts and serving as a lead and knowledgeable specialist for the team. Responsibilities include acting as a role model and resource for staff, assisting with difficult accounts, troubleshooting, and providing advice and support. The role may be assigned to specialized areas of PB Financial Services requiring advanced knowledge and will respond to inquiries from patients, physicians, payers, and attorneys regarding account status. Additionally, this position trains staff, assists supervisors in assessing competencies, and works on special projects as needed.

Responsibilities

• Manage and resolve complex, high-level accounts and transactions in a timely manner.
• Take appropriate billing, collections, or customer service actions to resolve accounts.
• Serve as a lead and resource for staff, providing coaching and support on difficult accounts.
• Troubleshoot issues and provide advice and direction to the team.
• Respond to inquiries from patients, physicians, payers, and attorneys regarding account status.
• Train staff and assist supervisors in assessing staff competencies.
• Work on special projects and other assignments as needed.
• Exercise discretion in managing sensitive information, including patient records, financial data, and strategic plans.
• Ensure compliance with data protection and privacy policies and laws.

Requirements

• Strong math skills to perform calculations related to patient accounting.
• Ability to analyze, think critically, and problem-solve.
• Minimum 5 years of experience in collections in outpatient and hospital settings.
• Excellent written and verbal communication skills in English.
• Excellent understanding of capitation and commercial HMO.
• Demonstrated strong listening, collaboration, and team-orientation skills.
• Ability to achieve monthly productivity standards.
• Advanced knowledge of revenue cycle processes in a healthcare setting.
• Advanced knowledge of medical professional fee billing, including Medi-Cal, Medicare, MSI, Champus, and commercial insurance carriers.
• Ability to review and analyze patient accounts to effectively bill and/or collect revenue for professional medical services rendered.
• Ability to resolve routine and non-routine matters independently.
• Ability to maintain a work pace appropriate to the workload.
• Ability to establish and maintain effective working relationships across the Health System.

Preferred Qualifications

• Prior experience as a lead.
• Knowledge of University and medical center organizations, policies, procedures, and forms.

Benefits

We offer a wealth of benefits to make working at UCI even more rewarding, which may include:

• Medical insurance
• Sick and vacation time
• Retirement savings plans
• Access to a number of discounts and perks

Conditions of Employment

As a condition of employment, the following requirements apply:

• Background check and Live Scan.
• Disclosure of any final administrative or judicial decisions involving misconduct within the last seven years.
• Legal right to work in the United States.
• Compliance with vaccination policies.
• Adherence to smoking and tobacco policy.
• Drug-free environment.
• Exercise utmost discretion in managing sensitive information.
• Additional conditions may apply, such as compliance with the California Child Abuse and Neglect Reporting Act, E-Verify, and pre-placement health evaluation.