Analysis Skills, Communication Skills, Contract Analysis, Contract Processing, Credit and Collections, Current Procedural Terminology (CPT), Detail Oriented, Establish Priorities, Health Maintenance Organization (HMO), Healthcare Common Procedure Coding System (HCPCS), Healthcare Reimbursement, High School Diploma, Insurance, Managed Care, Medi-Cal, Medical Billing, Medical Terminology, Microsoft Excel, Microsoft Office, Microsoft Word, Organizational Skills, Outpatient Care, Patient Care, Preferred Provider Organization (PPO), Presentation/Verbal Skills, Problem Solving Skills, Safety Codes, Safety/Work Safety, Spreadsheets, Team Player, Third-Party Payer, Time Management, Writing Skills
General Information
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Work Location: Los Angeles, CA, USA
Onsite or Remote
Flexible Hybrid
Work Schedule
Monday-Friday 7:30 AM - 4:30 PM
Posted Date
11/03/2025
Salary Range: $27.65 - 39.27 Hourly
Employment Type
2 - Staff: Career
Duration
Indefinate
Job #
27360
Primary Duties and Responsibilities
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As a Medi-Cal Collections Representative, you will manage a designated portfolio of inpatient and outpatient claims, ensuring effective and efficient collection efforts. Your primary responsibilities include:
- Conducting regular account reviews to identify outstanding balances.
- Initiating and maintaining communication with third-party payers to resolve reimbursement discrepancies.
- Diligently following up on claims to ensure timely resolution.
- Communicate with insurance providers, patients, and internal departments to gather necessary information and resolve payment issues.
Salary Range: $27.65- $39.27/hourly
Job Qualifications
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We are seeking a self-directed, detail-oriented individual with:
- 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
U
University of California