Collector II
Costa Mesa, CA- 92626
3 month 

Work Schedule m-f 7 AM – 3:30 PM EPIC Hyperspace experience REQUIRED.

Job Summary:

• The Collector serves as the account representative for client in working with insurance companies, government payors, and/or patients for resolution of payments and accounts resolution. 
• -Completes assigned accounts within assigned work queues. 
• -Obtains the maximum amount of reimbursement by evaluating claims at the contract rate with the use of the contract management tool for proper pricing (Examples: APC, DRG, APRDRG). 
• -Reviews and initiates the initial appeal for underpayments observing all timely requirements to secure reimbursement due to client. 
• – Reviews and completes payor and/or patient correspondence in a timely manner. 
• -Escalates to the payor and/or patient accounts that need to be appealed due to improper billing, coding and/or underpayments. 
• -Reports new/unknown billing edits to direct supervisor for review and resolution. 
• -Has a strong understanding of the Revenue Cycle processes, from Patient Access (authorizations & admissions) through Patient Financial Services (billing & collections), including procedures and policies. 
• -Has thorough knowledge of managed care contracts, current payor rates, understanding of terms and conditions, as well as Federal and State requirements. 
• -Interprets Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to ensure proper payment as well as assist and educate patients and colleagues with understanding of benefit plans. 
• -Understanding of hospital billing form requirements (UB04) and familiar with the HCFA 1500 forms. 
• -Knowledge of HMO, POS, PPO, EPO, IPA, Medicare Advantage, Covered California (Exchange), capitation, commercial and government payors (i.e. Medicare, Medi-Cal, TriCare, etc) and how these payors process claims. 
• -Demonstrates knowledge of and effectively uses patient accounting systems. 
• -Documents all calls and actions taken in the appropriate systems. 
• -Accurately codes insurance plan codes. 
• -Establishes a payment arrangement when patients are unable to pay in full at the   me payment is due. 
• -May review for applicable cash rates, special rates, applicable professional and employee discounts. 
• -May process bankruptcy and deceased patient accounts. 
• -Performs other duties as assigned. 
• -Consistently meets individual productivity and quality assurance standards In addition to the above, the Collector II demonstrates proficiency in the functions mentioned above. 
• -Assists in multiples areas, payors or departments. 
• – Assist with special projects and/or additional tasks as needed. 
• -Able to problem solve issues as they arise and independently research as needed for resolution. 
• -Provides support and assists with training of peers as needed. 
• -Exceeds individual productivity and quality assurance standards for at least 6 consecutive months. 
• -No corrective action within the last 6 months.
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Required Skills & Experience:

• -Three years of experience in a hospital/medical and/or related field or strong background in customer service.
• -Working knowledge of Epic Resolute, Eric Care, and Epic CPOE.
• -Intermediate Excel knowledge is a must.
• -Diversity
• -Technology & Equipment Skills
• -Interpersonal Skills 
• -Job Knowledge
• -Oral/Written Communication
• -Travel
• -Organization Behavioral Competencies
• -BUSINESS ACUMEN 
• -CUSTOMER SATISFACTION 
• -INNOVATION
• -TRUST & ACCOUNTABILITY