Medical Collector

University of California System•Anaheim, CA

43d

About The Position

UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region. Listed among America's Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County's only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County. To learn more about UCI Health, visit www.ucihealth.org. Position Summary: Under the general supervision and direction of the Billing Manager, the incumbent is responsible for performing a critical function for the Physicians Billing Group (PBG) and its clientele by taking the appropriate billing, collections, or Customer Service actions to resolve an account. This requires an understanding of payer guidelines for Medicare, Medi-Cal (and its affiliates), Commercial Insurance, Workers Compensation, and various other insurance carriers. Depending on the unit the Collections Representative is assigned to, the incumbent may be required to perform any or all of the following duties: work billing editing error report(s) prior to the submittal of claims to ensure that claims are billed cleanly and free of errors, leading to prompt and maximum pro-fee reimbursement; collecting on insurance invoices/accounts with balances as generated and outlined on assigned account receivable worklists, aging reports, system target files and correspondence received and assigned.

Requirements

Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
Must demonstrate customer service skills appropriate to the job
Experience in medical professional fee billing to include Medi-Cal, Medicare, MSI, Champus and commercial insurance carriers. Understanding of capitation and commercial HMO.
Excellent written and verbal communication skills in English
Effectively review and analyze patient account to effectively bill and or collect revenue for professional medical services rendered.
Ability to maintain a work pace appropriate to the workload
Ability to establish and maintain effective working relationships across the Health System
Ability to achieve monthly productivity standards.

Nice To Haves

Working knowledge and experience with patient registration and authorization process.
Well-developed verbal and written communication skills.
Possess knowledge of and skill in using payor websites to assess claim status or to follow-up on collections process.
Knowledge of University and medical center organizations, policies, procedures and forms
Experience with the Epic Billing System
Experience in professional fee medical collections.

Responsibilities

work billing editing error report(s) prior to the submittal of claims to ensure that claims are billed cleanly and free of errors, leading to prompt and maximum pro-fee reimbursement
collecting on insurance invoices/accounts with balances as generated and outlined on assigned account receivable worklists, aging reports, system target files and correspondence received and assigned.