Collector 3 at Loma Linda

San Bernardino, California, United States -

Full Time

Start Date

Immediate

Expiry Date

23 Jun, 26

Salary

30.02

Posted On

25 Mar, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Managed Care Contract Interpretation, Insurance Follow-up, Third Party Payer Relations, Compliance Adherence, Payment Methodologies, Reimbursement Analysis, Collection Recovery Strategies, Staff Training, Staff Mentoring, Automated Billing Systems, Adjudication Systems, UB04, CPT, HCPC, ICD10, EOB

Industry

Hospitals and Health Care

Description

Job Summary: The Collector 3 analyzes and interprets Managed Care contract language, terms, conditions and responsibility matrices. Performs telephone and written follow-up with insurance companies, third party payers, worker's compensation payers, medical groups, outside hospitals, and physician's offices to ensure timely payments for inpatient and outpatient hospital bills in accordance with the terms and conditions of each contract and/or insurance company�s policies. Ensures that payers adhere to compliance laws regarding timely processing of claims. Has expert understanding of Managed Care and insurance company payment methodologies, principles, rules, and regulations to perform reimbursement from both the third party and patient perspectives. Determines if payer needs additional information, identifies barriers, or secures payment dates. Is responsible for following through with requested information as needed in order to remove payment barriers or escalates the account to LLUH Management or Payer Management. Develops collection recovery strategies with each payer. Pursues each outstanding account to reach maximum reimbursement and closure. Trains and mentors new and existing staff. Performs other duties as needed. Education and Experience: Minimum five year of experience in in healthcare billing, auditing, managed care or collections required; preferably in hospital billing. Knowledge and Skills: Expert knowledge of automated billing, follow-up and adjudication systems required (LLEAP/Epic, Assurance, DDE, FISS, Medi-Cal website, and Noridian Medicare Portal). Expert knowledge of UB04, CPT, HCPC, ICD10, and EOB required. Able to 10-Key. Able to read, write legibly; speak in English with professional quality; use computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint). Operates and troubleshoots basic office equipment required for the position. Able to relate and communicate positively, effectively, and professionally with others; work calmly and respond courteously when under pressure; collaborate and accept direction. Able to communicate effectively in English in person, in writing, and on the telephone; think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position. Licensures and Certifications: None. Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness. Loma Linda University Health is a Seventh-day Adventist, faith and values based Christian institution. Candidates must understand and embrace the mission, purpose, and identity of Loma Linda and its affiliated entities. We are an equal opportunity employer committed to the principles of diversity. We provide equal opportunities in all aspects of the employment process to every individual, regardless of gender, race, color, age, national origin, ancestry, physical or mental disability, marital or veteran status, genetic information or any other characteristic protected by law. In addition, we will provide reasonable accommodations for otherwise qualified individuals requesting an accommodation due to a disability. If you need accommodation assistance with accessing our job listings or completing an application, or during any other phase of employment with us, please contact Human Resources Management at (909) 651-4001. Loma Linda University Shared Services is a religiously-qualified Equal Opportunity Employer under Title VII of Civil Rights Act of 1964. No question on this application is asked for the purpose of unlawfully limiting or excluding any applicant’s consideration for employment because of race, color, religion, gender, age, national origin, disability, genetic information, or any other status protected by applicable law. If you need a reasonable accommodation in the hiring process, please notify Human Resource Management. We appreciate your interest in Loma Linda and wish you success in your job search!

Responsibilities

The Collector 3 analyzes Managed Care contracts and performs follow-up with various payers via phone and writing to ensure timely payments for hospital bills according to contract terms. This role involves developing collection strategies, pursuing outstanding accounts for maximum reimbursement, and training/mentoring staff.