Medi-Cal Collections Representative

UCLA Health • Los Angeles, CA

100d • $26 - $38 • Hybrid

About The Position

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, and communicating with insurance providers, patients, and internal departments to gather necessary information and resolve payment issues.

Requirements

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

Responsibilities

• 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.
• Communicate with insurance providers, patients, and internal departments to gather necessary information and resolve payment issues.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Hospitals
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees