Works under the supervision of the Billing and Collection Supervisor. Analyzes and interprets Managed Care contract language, terms, conditions and responsibility matrices. Performs telephone and written follow-up with patients, insurance companies, third party payers, worker’s compensation payers, medical groups, outColleside hospitals and physician’s offices to ensure timely payments. Has a strong understanding of CMS regulations, Managed Care and insurance company payment principles, rules, and regulations. Is knowledgeable with the use of appropriate HCPCS, CPT 4 codes, Modifiers, ICD9 and ICD10 codes. Understands the billing and payment follow up time limits set forth by Medicare, payer contracts and has the knowledge of insurance billing rules and regulations. Has the ability to utilize multiple hospital systems. Performs other duties as needed.

PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.

Required Skills

• Strong verbal and written communication skills
• Critical thinking skills
• Problem solving skills
• Computer Skills
• Knowledgeable with AB1455 regulations 
• Knowledgeable with payer contract language

Required Experience

• High school graduate. Associate's Degree or higher preferred.
• LA City Fire Card within 6 months of employment.
• Previous experience working in an acute hospital patient account setting required.
• Minimum of 2 years’ experience in hospital collections required.
• Customer service experience.