We are looking for a Medical Collections Specialist to join our team in Costa Mesa, California. The role will focus on working with insurance companies, government payors, and patients for the resolution of payments and accounts. The successful candidate will be responsible for evaluating claims, initiating appeals for underpayments, reviewing and completing payor and patient correspondence, and documenting all actions taken in the appropriate systems.Responsibilities:• Evaluate claims at the contract rate for proper pricing• Initiate the initial appeal for underpayments• Review and complete payor and patient correspondence in a timely manner• Escalate to the payor and patient accounts that need to be appealed due to improper billing, coding, and underpayments• Report new/unknown billing edits to the supervisor for review and resolution• Demonstrate a strong understanding of the Revenue Cycle processes, including patient access (authorizations & admissions) through patient financial services (billing & collections)• Exhibit thorough knowledge of managed care contracts, current payor rates, understanding of terms and conditions, as well as Federal and State requirements• Interpret Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to ensure proper payment• Understand hospital billing form requirements (UB04) and familiar with the HCFA 1500 forms• Demonstrate 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• Accurately code insurance plan codes• Establish a payment arrangement when patients are unable to pay in full at the time payment is due• May review for applicable cash rates, special rates, applicable professional and employee discounts• May process bankruptcy and deceased patient accounts.