Medi-Cal Collections Representative

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Onsite or Remote

Flexible Hybrid

Work Schedule

Monday - Friday, 7:00 AM - 4:00 PM

Posted Date

11/01/2024

Employment Type

Duration

Indefinite

Job #

20306

As a Medi-Cal 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.
• Communicating with insurance providers, patients, and internal departments to gather necessary information and resolve payment issues.

$26.79 - $38.05/hourly

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 proficiency in Excel and spreadsheets.
• Understanding of collection techniques and laws, including AB1455, the Knox-Keene Act, Health & Safety Codes, etc., and 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.