Senior Collections Representative

The Senior Collections Representative (Rep.) aka Government Sr. Follow-up Collector handles the following:

• Responsible for collections, conducting proactive follow-up with payers regarding non-payments, underpayments, or incorrect payments in a stratified manner. 
• Calculates expected reimbursement to verify expected payments versus actual payments received. 
• Disputes with payers for denials and/or underpayments. 
• Reconciles the accounts to closure. 

In addition, the Rep. is collector is knowledgeable of assigned payer claim requirements and regulations and utilizes multiple databases and applications to analyze and take appropriate action on information or documents received.  Applications and Databases consist of EPIC, Hospital Rates, CIRIUS, RevCyclePro, Imaging, DDE and various payer websites. Frequent contact with Patient Financial Services staff, departments and management, as well as patients, billing and professional fee and collection services vendors.

Responsibilities

The Senior Collections Representative (Rep.) aka Government Sr. Follow-up Collector handles the following:

• Responsible for collections, conducting proactive follow-up with payers regarding non-payments, underpayments, or incorrect payments in a stratified manner. 
• Calculates expected reimbursement to verify expected payments versus actual payments received. 
• Disputes with payers for denials and/or underpayments. 
• Reconciles the accounts to closure. 

In addition, the Rep. is collector is knowledgeable of assigned payer claim requirements and regulations and utilizes multiple databases and applications to analyze and take appropriate action on information or documents received.  Applications and Databases consist of EPIC, Hospital Rates, CIRIUS, RevCyclePro, Imaging, DDE and various payer websites. Frequent contact with Patient Financial Services staff, departments and management, as well as patients, billing and professional fee and collection services vendors.

Qualifications

Requirements:

• Minimum of two or more years of experience in a hospital billing office environment.
• High school graduates or GED certificate.
• Internals Applicants: Must demonstrate an in-depth understanding of all aspects of billing greater than an Office Assistant III.
• Knowledge of contracts, insurance billing requirements, UB04 claim forms, Medicare, Medi-Cal and compliance program regulations.
• Good analytical and organizational skills, interpersonal, verbal, and written communication skills.
• Knowledge of computer operation, keyboard functions, calculator, copier and fax machine operation.
• Adequate keyboard skills.
• Proactive and assertive account resolution skills. 
• Must be a motivated individual with a positive and exceptional work ethics.
• Ability to follow directions and written procedures.
• Ability to balance assertiveness with compassion for the patient and others.
• Must have a thorough understanding of CPT, ICD, DRG, and HCPC codes.
• Must have a thorough understanding of stop losses, per diems, carve outs and other contract terms and conditions.
• Computer software skills (i.e. Microsoft Applications and E-mail, etc.)
• The ability to work onsite in Emeryville a min. of one day a week or more when required. 

Preferences:

• Medical terminology experience. 
• ICD, CPT4, HCPCS, DRG coding experience.
• Understanding of HIPAA rules and regulations