Description

As a Commercial 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: $27.65 - $39.27 /hourly

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

Commercial Hospital Collections Representative

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