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Managed Care Collector 2 in Santa Fe Springs, CA at Avanti Hospitals

Date Posted: 5/9/2019

Job Snapshot

Job Description

Central Business Office

Job Title: Managed Care Collector 2 

City: Santa Fe Springs / State: California    

Central Business Office

Day Shift

From 8:00 AM

To 4:30 PM

                                      


Job Description and Job Responsibilites

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. Responsible for High Dollar and Sub-acute accounts. Have the ability to help reduce aging AR. Work with Manager on special projects. Assist Manager in the absence or Lead. 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.
  • Follow up on High Dollar and Sub-Acute accounts.
  • 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.
  • Demonstrate the ability to create follow-up claim status spreadsheet for payors.
  • 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.
  • Demonstrate the ability to reduce aging AR.
  • Attend payor and Vendor webinars as needed.
  • Handles all clients in a courteous and professional manner.
  • Ensures contractuals/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.
  • Work with Manager and or Lead on special projects.
  • Assist Manager in the absence of Lead.
  • 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. 




Job Requirements

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

Licensure/Certifications:

  • N/A

ADA/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.

 

Job Requirements

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

Licensure/Certifications:

  • N/A

ADA/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.