Managed Care Collector in Santa Fe Springs, CA at Pipeline Health

Date Posted: 10/3/2022

Job Snapshot

Job Description

Job Title:

Managed Care Collector

Job Summary:

Responsible for collecting on assigned accounts in a professional and timely manner. Work with Insurance companies and other payors to resolve accounts efficiently. Must be able to multi-task and have knowledge of contract language.

Reports To:

Managed Care Manager, and or CBO Director

Essential Job Duties:

• Demonstrates competency in the quality of work and knowledge of the job pertinent to the functioning of the position of Collector.

• Follows up on all accounts after billing until payment is received.

• Reviews and follows up on aged accounts with documentation in an efficient and thorough manner with accuracy.

• Ensures appropriate phone calls/or website status towards resolution on each account.

• Ensures re-bills to payors as needed and change update to correct plan IDs.

• Prepares appeals on denials and underpayments.

• Mails follow-up letters to patients/ insurance companies as needed.

• Consistently exercises sound judgment in arranging account settlement plans.

• Prepares accounts settlement options in a clear and persuasive manner.

• Works accounts on work ques/reports provided, averaging a minimum of 45-55 per day.

• Handles all clients in a courteous and professional manner.

• Ensures contractual/discounts are applied to accounts as specified in each contract.

• Refers an account to a biller and forwards a copy of the primary carrier’s EOB if a secondary insurance is applicable.

• Follows up on all correspondence requiring action as needed.

• Retrieves Patient records from the HBF system as needed.

• Demonstrates the ability to recognize and deal with priorities in order to complete work in a timely manner.

• Performs all other duties and projects as assigned. Behavioral Standards:

• Exhibits customer and service oriented behaviors in every day work interactions.

• Demonstrates a courteous and respectful attitude to internal workforce and external customers.

• Communicates accurately and appropriately.

• Works well and efficiently under minimal supervision.

• Handles difficult situations in a discreet and professional manner.

• Is adaptable to changes in assignments and priorities. Communication/Knowledge:

• Provides accurate and timely written and verbal communication of information in a manner that is understood by all.

• Able to listen, understand, problem-solve, and carry-out duties to ensure the optimal outcome.

• Able to use IT systems in an accurate and proficient manner. Collaboration/Teamwork:

• Contributes toward effective, positive working relationships with internal and external colleagues.

• Demonstrates cooperation, flexibility, reliability, and dependability in all daily work activities and a willingness to collaborate with others for the good of the customer and the organization.

Education/Experience:

• High school graduate or equivalent required

• Prefer at least 2 to 3 years of current experience in an acute care hospital setting

• Knowledge of contracts • Computer skills preferred

Physical Demands:

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Such accommodations must be requested by the employee/applicant in order to be considered.

• Required to stand; walk; sit; use hands to fingers, handle, or feel; reach with hands and arms; stoop, kneel, crouch, or crawl; talk and hear; and may taste and smell. The employee is regularly required to lift, push and/or pull weights in excess of 10 pounds, with assistance. Visual abilities, auditory abilities, must be intact to perform duties.