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Posted: 08-Sep-25
Location: Los Angeles, California
Categories:
Internal Number: 148946174
As a Medicare 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.
- Communicate with insurance providers, patients, and internal departments to gather necessary information and resolve payment issues.
Salary Range: $26.79 - $38.05/hourly
- 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
