Senior Collections Representative

Our Senior Collections Representation aka Government Sr. I Follow-up Collector is responsible for collections, conducting proactive follow up with payers regarding non-payments, underpayments, or incorrect payments in a stratified manner.  Duties include, but not limited to the following: 

• Calculates expected reimbursement to verify expected payments versus actual payments received; 
• Files disputes with payers for denials and/or underpayments;
• Reconciles the accounts to closure;
• Utilizes multiple databases and applications to analyze and take appropriate action on information or documents received.  Applications and Databases consist of: EPIC, Hospital Rates, CIRIUS, RevCyclePro, Imaging, DDE and various payer websites; and 
• Frequently interacting with the Patient Financial Services staff, departments and management, as well as patients, billing and professional fee and collection services vendors, and must be knowledgeable of assigned payer claim requirements and regulations.   

Responsibilities

Our Senior Collections Representation aka Government Sr. I Follow-up Collector is responsible for collections, conducting proactive follow up with payers regarding non-payments, underpayments, or incorrect payments in a stratified manner.  Duties include, but not limited to the following: 

• Calculates expected reimbursement to verify expected payments versus actual payments received; 
• Files disputes with payers for denials and/or underpayments;
• Reconciles the accounts to closure;
• Utilizes multiple databases and applications to analyze and take appropriate action on information or documents received.  Applications and Databases consist of: EPIC, Hospital Rates, CIRIUS, RevCyclePro, Imaging, DDE and various payer websites; and 
• Frequently interacting with the Patient Financial Services staff, departments and management, as well as patients, billing and professional fee and collection services vendors, and must be knowledgeable of assigned payer claim requirements and regulations.   

Qualifications

Requirements:

• High school diploma or GED.

• Minimum of two or more years of experience in a hospital billing office environment.

• Applicable to Internal candidates only:  Must demonstrate an in-depth understanding of all aspects of billing greater than an Office Assistant III.

• Knowledge of contracts, insurance billing requirements, UB04 claim forms, Medicare, Medi-Cal and compliance program regulations.

• Good analytical and organizational skills, interpersonal, verbal, and written communication skills.

• Knowledge of computer operation, keyboard functions, calculator, copier and fax machine operation.

• Adequate keyboard skills.

• Proactive and assertive account resolution skills. 

• Must be a motivated individual with positive and exceptional work ethics.

• Ability to follow directions and written procedures.

• Ability to balance assertiveness with compassion for the patient and others.

• Must have an understanding of CPT, ICD, DRG, and HCPC codes and an understanding of stop losses, per diems, carve-outs and other contract terms and conditions.

• Computer software skills (i.e. Microsoft Applications and E-mail, etc.)

• The ability to work in Emeryville one day a week or when required.  

Preferences:

• Medical terminology experience. 

• ICD, CPT4, HCPCS, DRG coding experience.

• Understanding of HIPAA rules and regulations.