TITLE:  Collector II

LOCATION: Costa Mesa, CA

SCHEDULE:  Days 100% Onsite 

PAY:$20.00 - $28.00/ hour

This is the pay range that BAHAMA Consulting reasonably expects to pay someone for this position.

FLSA STATUS: Non-Exempt 

SUMMARY:  The Collector serves as the account representative for Hoag in working with insurance companies, government payors, and/or patients for resolution of payments and accounts resolution.

RESPONSIBILITIES: 

• Completes assigned accounts within assigned work queues.
• Obtains the maximum amount of reimbursement by evaluating claims at the contract rate with the use of the contract management tool for proper pricing (Examples: APC, DRG, APRDRG).
• Reviews and initiates the initial appeal for underpayments observing all timely requirements to secure reimbursement due. 
• Reviews and completes payor and/or patient correspondence in a timely manner. 
• Escalates to the payor and/or patient accounts that need to be appealed due to improper billing, coding and/or underpayments.
•  Reports new/unknown billing edits to direct supervisor for review and resolution. Has a strong understanding of the Revenue Cycle processes, from Patient Access (authorizations & admissions) through Patient Financial Services (billing & collections), including procedures and policies.
• Has thorough knowledge of managed care contracts, current payor rates, understanding of terms and conditions, as well as Federal and State requirements. 
• Interprets Explanation of Bene?ts (EOBs) and Electronic Remittance Advices (ERAs) to ensure proper payment as well as assist and educate patients and colleagues with understanding of bene?t plans. 
• Understanding of hospital billing form requirements (UB04) and familiar with the HCFA 1500 forms. Knowledge of HMO, POS, PPO, EPO, IPA, Medicare Advantage, Covered California (Exchange), capitation, commercial and government payors (i.e. Medicare, Medi-Cal, TriCare, etc) and how these payors process claims.

EDUCATION & EXPERIENCE:

• High School Diploma 
• Three years of experience in a hospital/medical and/or related ?eld or strong background in customer service.
• Working knowledge of Epic Resolute, Eric Care, and Epic CPOE.
• Intermediate Excel knowledge is a must.

Benefits: Medical, Dental, Vision, HSA, Employee Assistance Program (EAP), STD, LTD, Life and 401(K)

BAHAMA Consulting is an equal opportunity employer. If you need accommodation for any part of the application and hiring process or have any questions, please contact HR.