Non-Government Collector - Patient Accounting - Full Time 8 Hour Days (Non-Exempt) (Non-Union)

University of Southern California•Los Angeles, CA

2d•$26 - $41

About The Position

The Non-Government Collector manages patient accounts from discharge through billing edits, contract management and account net-down, through final collection of expected reimbursement. The role follows up with non-governmental payers to liquidate submitted inventory, validates underpayments and payment variances, and follows provider dispute guidelines. The collector is responsible for accounts with contracted insurance as the primary or current payer and maintains knowledge of governmental payer billing standards and collection requirements. The position requires billing and collections knowledge, including Medicare, Medi-Cal and local Medi-Cal entities, as well as familiarity with TARS and SARs processes. The collector communicates with payers and customers, resolves payment delays, denials, credit balances and underpayments, documents account activity, and works to ensure reimbursement in accordance with contracted rates. The role also contributes to process improvements, policy and procedure development, and department workflow support.

Requirements

High school graduate or equivalent.
One to two years of experience; combined education and experience may substitute for the minimum experience.
Previous collection experience.
Fire and Safety Certification; if not held at hire, it must be obtained within 30 days of hire and renewed before expiration.

Responsibilities

Manage patient accounts from discharge through billing edits, contract management, account net-down and collection of expected reimbursement.
Follow up with non-governmental payers using work lists to liquidate submitted inventory.
Validate underpayments and payment variances and follow provider dispute guidelines.
Keep current on billing and collections changes affecting Medicare, Medi-Cal and local Medi-Cal entities.
Apply working knowledge of TARS and SARs processes and follow-up.
Perform billing, account follow-up and appeals necessary to liquidate accounts payable.
Identify improvement opportunities and develop and implement effective solutions when appropriate.
Contact payers by phone or mail regarding delayed payments or underpayments.
Handle customer calls and payer inquiries accurately, including charge inquiries and account status questions.
Process correspondence within five days of receipt.
Resolve credit balances, underpayments and denials in a timely manner and take appropriate action to ensure accounts are paid at contracted rates.
Maintain knowledge of contract payers, rates and agreements, and ensure accurate insurance coding.
Evaluate reimbursement to ensure maximum payment for services and appeal underpayments.
Obtain patient eligibility information from health plans or insurance contract websites, update insurance, and/or forward claims to medical groups for updates.
Use knowledge of the payer matrix of financial responsibility to perform appropriate account follow-up.
Document account activity online, including manually calculated expected reimbursement amounts.
Use initiative and follow through to resolve problems, documenting involvement in patient or department issues.
Identify workflow problems and use available resources to maintain productive workflows.
Assist others as workload changes within the department.
Keep the supervisor informed of problems that may prevent timely completion of work.
Adapt to unusual circumstances and changes while promoting cooperation and minimizing disruption.
Participate in reviewing, revising and developing departmental policies and procedures.
Perform other duties as assigned.