We are seeking Professional Physican Collectors (Level II and III)
Remote locations only:
- Georgia
- Iowa
- Missouri
- Nebraska
- North Carolina
- Tennessee
- Texas
- Utah
- Wisconsin
- Wyoming
Indiana
Primary Duties and Responsibilities
- The Collector serves as the account representative for Hoag 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 Hoag.
- 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 Admittance 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 time 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.
- Performs other duties as assigned.
- 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.
Education and Experience
- High school diploma or equivalent required.
- Three years of experience in a hospital/medical and/or related field or strong background in customer service.
- Working knowlege of Epic Resolute, Eric Care, and Epic CPOE.
- Intermedicate Excel knowledge is a must.
License Required
N/A
License Preferred
N/A
Certifications Required
N/A
Certifications Preferred
N/A
Skills Required
- High school diploma or equivalent
- Three years experience in a hospital/medical field or strong customer service background
- Working knowledge of Epic Resolute, EpicCare (Epic), and Epic CPOE
- Intermediate Microsoft Excel skills
- Familiarity with UB04 and HCFA 1500 billing form requirements
- Knowledge of managed care contracts, payor types (Medicare, Medi-Cal, commercial, Medicaid, Medicare Advantage, etc.)
- Experience using patient accounting systems and documenting actions in system
Hoag Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Hoag and has not been reviewed or approved by Hoag.
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Healthcare Strength — Health, dental, vision, mental health, disability, and wellness programs are extensive, with additions like FSAs and pet insurance. These offerings are presented as comprehensive and a meaningful component of total rewards.
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Leave & Time Off Breadth — Generous PTO, paid holidays and sick time, and parental leave feature prominently. These time-off provisions are described as supportive of work-life balance across roles, including fellowship programs.
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Career-Linked Recognition & Rewards — Tuition reimbursement, continuing education stipends, certification bonuses, and a clinical ladder link development to higher pay and broader involvement. Promote-from-within practices further connect performance and growth to compensation over time.
Hoag Insights
What We Do
Since 1952, Hoag has been serving the local communities of Orange County by providing personalized health care services of an unsurpassed level. Hoag Digital Health is a new customer-centric product management, design, and engineering unit on a mission to bring together Hoag's nationally renowned care in key medical specialties with the everyday experience of primary, urgent, and preventative care and well-being through a variety of digital mediums.
Why Work With Us
To date, we have been helping fundamentally rethink the care experience for multiple customer groups with hybrid digital-physical solutions – from becoming go-to guides for first-time parents delivering at Hoag through re-imagining the primary care and annual wellness experience to improving Hoag’s “digital front doors,” including its websites.
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