Job Summary: The Collector 2 analyzes and interprets Managed Care contract language, terms, conditions and responsibility matrices. Performs telephone and written follow-up with insurance companies, government payers, third party payers, worker's compensation payers, medical groups, outside hospitals, and physician's offices to ensure timely payments for inpatient and outpatient hospital bills in accordance with the terms and conditions of each insurance companies' policies. Ensures that payers adhere to compliance laws regarding timely processing of claims. Determines if payer needs additional information, identifies barriers, or secures payment dates. Is responsible for following through with requested information as needed in order to remove payment barriers or escalates the account to LLUH Management or Payer Management. Develops collection recovery strategies with each payer. Pursues each outstanding account to reach maximum reimbursement and closure. Performs other duties as needed.
Education and Experience: Minimum three years of experience in healthcare billing, auditing, managed care or collections required; preferably in hospital billing.
Knowledge and Skills: Intermediate knowledge of automated billing, follow-up and adjudication systems required (LLEAP/Epic, Assurance, DDE, FISS, Medi-Cal website, and Noridian Medicare Portal). Intermediate knowledge of UB04, CPT, HCPC, ICD10, and EOB required. Able to 10-Key. Able to read, write legibly; speak in English with professional quality; use computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint). Operates and troubleshoots basic office equipment required for the position. Able to relate and communicate positively, effectively, and professionally with others; work calmly and respond courteously when under pressure; collaborate and accept direction. Able to communicate effectively in English in person, in writing, and on the telephone; think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.
Licensures and Certifications: None.
Skills Required
- Minimum three years of experience in healthcare billing, auditing, managed care, or collections
- Hospital billing experience
- Intermediate knowledge of automated billing and adjudication systems (LLEAP/Epic, Assurance, DDE, FISS, Medi-Cal website, Noridian Medicare Portal)
- Intermediate knowledge of UB04, CPT, HCPC, ICD10, and EOB
- Proficiency with 10-Key
- Proficient with Microsoft Word, Excel, Outlook, and PowerPoint
- Ability to communicate effectively in English in person, in writing, and on the telephone
- Ability to operate and troubleshoot basic office equipment
- Ability to manage multiple assignments, prioritize workload, work independently, and solve problems
- Sufficient hearing, vision, and color distinction to perform job duties
What We Do
Loma Linda is an industry leader in plant-based foods, providing a wide variety of vegetarian and vegan products, including meat analogues. Founded in 1905, the brand focuses on offering affordable, sustainable, and healthy sources of plant-based protein to help people live healthier, longer lives. It is currently owned by Century Pacific North America Enterprise Inc. as part of its family of plant-based brands.
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