NPH Medi-Cal Collections Representative

Description Patient Business Services

As a Medi-Cal Fee For Service 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: $29.03- $41.23/hourly

Qualifications

We are seeking a self-directed, detail-oriented individual
with:

• High
  school diploma or GED; Minimum of 3 years of relevant experience,
  including at least 1 year in collections investigation

• Experience
  in Medi-Cal Fee For Service and Medi-Cal 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