Collections Specialist Hospital - Business Office - Full Time - Days - 8hr

Emanate Health Foothill Presbyterian Hospital • Covina, CA

23h • Onsite

About The Position

This position is responsible for performing account follow-up from various third-party payers, including traditional commercial insurance carriers, Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), EPO's, International Payers, Auto Liability, and other Liability carriers, as well as all other non-governmental third-party payers. Key duties encompass collections, appeals, billing, adjustments, EOB review, correspondence management, and handling all types of denials. The role also involves working on special complex high-priority projects as assigned by management.

Requirements

• High School diploma or equivalent, or work experience in lieu of High School Diploma.
• Experience within an acute hospital setting, with strong emphasis on managed care contract and appeals/underpayment collection activities.
• Excellent customer service skills.
• Knowledge of collection techniques and collection laws (i.e. AB1455, Knox-Keene Act, Health & Safety Codes, etc.).
• Knowledge of medical terminology and CTP/HCPS codes.
• Knowledge of networks, IPA's, HMO's, PPO's and PCP's and contract affiliations.
• Strong analytical skills.
• Proficient with spreadsheets.
• No minimum license requirement.

Nice To Haves

• Bilingual Spanish.
• Three years' billing experience.

Responsibilities

• Perform account follow up from third-party payers including traditional commercial insurance carriers, Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), EPO's, International Payers, Auto Liability and other Liability carriers, and all other non-governmental third-party payers.
• Handle collections.
• Manage appeals.
• Perform billing.
• Process adjustments.
• Review EOBs.
• Manage correspondence.
• Manage all types of denials.
• Work on special complex high priority projects as assigned by management.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 501-1,000 employees