Sr. Collections Representative

Title: Sr. Collections Representative

Working Hours: 7:30 am - 4:30 pm

Location: Los Angeles CA

Assignment length: 4+ months contract with possibility of extension

Notes:

Minimum of 3 years of Hospital Collections within a hospital setting, with strong emphasis on Medi-Cal Managed Care contracts and appeals/underpayment collection activities.

Summary Statement:

• The Senior Follow-Up Collection Representative is responsible for Medi-Cal Managed Care accounts, all dollars with a special attention to high dollar. Collector is responsible for reviewing assigned inpatient and outpatient claims to ensure maximum collection dollars by providing appropriate follow-up and documenting actions taken. His/her major functions include managing a portfolio of assigned accounts, that are typically high balance and/or aged accounts or of a more complex nature, responding to correspondence, and heavy telephone contact to ensure timely follow-up and account resolution. The Senior Collections representative should assist with training follow-up collections representatives and also be a resource to collections representatives. The Senior collector must have the ability to perform all needed duties in the patient accounting systems. Skilled in the usage of Microsoft Word and Excel, and other programs as defined by the Patient Business Services management staff. Weekly Productivity Standards is 30 accounts daily (4.00 per hour) /150 accounts weekly.

Type Of Supervision Received:

• Daily meetings as needed. Also weekly Unit meetings and monthly Division meetings; Direct review of daily production and other production based reports in an effort to validate staff usage needs, portfolio reduction efforts, customer services and staff morale.

Job Duties:

• Understands billing / follow up and collection procedures and is able to balance all accounts correctly.
• Follows-up on previously billed accounts by reviewing accounts on a biweekly or monthly basis to determine possible sources of payment or payment problems.
• Contacts third party payers to establish reimbursement status, i.e., reason for any discrepancy between expected and actual reimbursed amounts and or date of issuance.
• If interim call backs to third party payors are warranted to verify documentation receipt or to expedite an aged account, independently calendars and completes follow-up activity.
• Reviews insurance correspondence / mail backs and responds to requests.
• Demonstrates ability in taking logical, decisive steps towards account resolution.
• Contacts other medical center departments (i.e., Admission, Utilization Review, Medical Records) to gain information necessary to adequately address payment issues.
• Contacts patient to obtain involvement to provide missing documentation, to track delayed insurance payment and/or to collect patient liability portion of bill. Forwards statements and/or form letters to patients advising of account status and indicating any action, which need to be taken.
• Reviews and maintains 'portfolio' of accounts responsible for, with optimum cash collections, adjustments, and closures.
• Resolves accounts in the aging category by collecting cash and/or applying appropriate adjustments in a timely manner.
• Reviews aged accounts and/or any accounts for which no telephone contact can be made or there is indication of payment delay or discrepancy, with supervisor for possible referral to collection agency, or legal assignment.

Prepares account for submittal to appropriate party per designated procedures if referral authorize

If the Client extend an offer then you have taken care below health screen process.

Vaccinations process- candidate have to bear the cost of health screen tests during the onboarding):

Fit Test

x

Kimberly Clark/Halyard N-95. PAPR allowed.

Immunization Flu shot

x

Oct 1- March 31/ can be extended per facility- Subject to change.

Immunization / Titer - Hep B or Declination

x

Declination, proof of completed 3 series vaccine series, or positive titer.

Immunization / Titer - MMR

x

Vaccine record of 2 series or positive IgG titer.

Immunization / Titer TDaP

x

Vaccine within 10 years of start date; declination acceptable.

Immunization / Titer Varicella

x

Vaccine record of 2 series or positive IgG titer.

TB Test

x

Proof of a negative TB test (QuantiFERON only) done within a year of the assignment start date; if positive, evidence of a clear chest x-ray done within 3 months of start date must be provided and a questionnaire from a physician concerning no active TB must be provided along with the x-ray results.