Collections Representative, Government Billing

Avispa Technology•Los Angeles, CA

4d•Hybrid

About The Position

A leading medical institution is seeking a Collections Representative, Government Billing to support the accurate and timely billing, collections, and account resolution of inpatient, outpatient, and laboratory claims. This role is responsible for ensuring compliance with government payer regulations, maintaining account accuracy, resolving billing issues, and maximizing reimbursement while delivering excellent customer service.

Requirements

2-5 years of Medicare billing and collections experience supporting inpatient and outpatient accounts.
Knowledge of hospital billing practices, government payer regulations, managed care contracts, and reimbursement processes.
Experience with electronic claims processing and patient accounting systems.
Proficiency in Microsoft Office, including Word and Excel.

Nice To Haves

Experience with healthcare billing software and payer portals is preferred.
Experience in billing government and third-party payers is preferred.
Knowledge of claim scrubbers, billing edits, and denial management processes is preferred.
Experience working in a hospital or healthcare revenue cycle environment is preferred.
Familiarity with medical records, authorizations, and supporting documentation requirements is preferred.

Responsibilities

Review, prepare, validate, and submit inpatient, outpatient, and laboratory claims to government and third-party payers, ensuring compliance with billing guidelines, payer requirements, claim accuracy, and timely filing regulations.
Investigate and resolve claim edits, denials, rejections, billing exceptions, missing documentation, authorization issues, and reimbursement discrepancies while maintaining accurate account records and billing system documentation.
Process account corrections, adjustments, transfers, rebills, write-offs, and account maintenance activities while updating payer, case, and patient information within patient accounting systems.
Monitor account activity, maintain productivity and quality standards, support reporting and process improvement initiatives, and communicate billing trends, issues, and operational concerns to leadership.
Provide professional support to patients, payers, and internal departments while ensuring HIPAA compliance, protecting patient confidentiality, and adhering to all regulatory, organizational, and billing compliance requirements.