Commercial Hospital Collections Representative

Requirements

• High school diploma or GED
• Minimum of 3 years of relevant experience, including at least 1 year in collections investigation
• Experience in commercial and managed care collections, highly desired
• Ability to interpret payer contracts and process contractual adjustments
• In-depth knowledge of UB04 requirements and medical billing processes
• Strong analytical skills and proven proficiency in Excel and spreadsheets
• Understanding of collection techniques and laws, including AB1455, the Knox-Keene Act, Health & Safety Codes, etc.
• Familiarity with medical terminology, CPT codes, HCPCS codes, health networks, IPAs, HMOs, PPOs, PCPs, and contract affiliations
• Excellent verbal and written communication skills
• Proficiency in Microsoft Office, especially Excel and Word
• Exceptional organizational skills, with the ability to meet deadlines, work independently or as part of a team, and prioritize tasks effectively