CHA Hollywood Presbyterian (CHA HPMC) is a nationally recognized acute care facility that has been caring for the Hollywood community and Los Angeles Areas since 1924.

Join our Global Network and be a CHA Global Ambassador

CHA HPMC is also a part of the world-renown CHA Health System (CHS). CHS has CHA University which consists of 14 education institutions including medical school, nursing school and pharmacy. CHA global network operates 81 hospitals and specialty clinics, 30 research and 31 bio/pharmaceutical/healthcare companies with 14,000 employees in seven countries.

Our New Facility is seeking for Top Talents

The best women’s hospital in Los Angeles is looking for current RN candidates to staff Operating Room, Emergency Department, Labor & Delivery and Mother-Baby care units to be housed in our expanding new patient tower facility scheduled to open next year. Come be a part of this dedicated and caring team right in the heart of Hollywood.

Position Summary:

• Analyzes and performs validation of claims payment against payer contract terms to ensure payer compliance. Requires detailed knowledge of contractual agreements, contract interpretation, reimbursement methodologies and configuration. Will work to identify payer specific trends and reports significant and recurring issues to the Revenue Recovery Specialist and the Revenue Recovery Supervisor.
• Primarily responsible for working in the payment variance work queue to identify payer specific trends and reports significant and recurring issues to the Revenue Recovery Specialist .
• Will work, as needed, on validation reports and report any recommendations on any configuration changes that need to be made to the Revenue Recovery Specialist II Must maintain and apply knowledge of complex hospital specific reimbursement methodologies.
• Must be a resource for hospital follow up and denial teams to answer reimbursement related questions.
• Demonstrates excellent analytical, problem solving, investigative and research ability during the configuration of contracts and fee schedules and throughout the validation process.
• Must report payer issues up to the Revenue Recovery Supervisor on payer compliance issues.
• Performs other related tasks and projects as assigned

Job Qualifications:

Minimum Education

• High School Diploma or GED

Preferred Education

• N/A

Minimum Work Experience and Qualifications:

• One to two years experience in a Hospital or Physician medical claims processing, insurance billing or insurance collections environment.
• Requires knowledge of Third Party Reimbursement and Contracts.
• Needs to be very detail orientated and have a thorough understanding of the life cycle of an insurance claim including being able to interpret payer 835 data.
• Must demonstrate strong analytical skills, strong interpersonal skills, and the ability to interface with various departments within the revenue cycle.
• Must also possess organizational skills, the ability to analyze reports and interpret various reimbursement models .
• Ability to communicate effectively verbally and in writing.
• Must be able to work in a union environment.

Preferred Work Experience and Qualifications:

N/A

Required Licensure, Certification, Registration or Designation:

Current Los Angeles County Fire Card required (within 30 days of employment