Medi-Cal Collections Representative

Academy of Managed Care Pharmacy

Los Angeles, CA

JOB DETAILS
SALARY
$27.65–$39.27 Per Hour
SKILLS
Analysis 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, Organizational Skills, Outpatient Care, Patient Care, Preferred Provider Organization (PPO), Presentation/Verbal Skills, Problem Solving Skills, Safety Codes, Safety/Work Safety, Team Player, Third-Party Payer, Time Management
LOCATION
Los Angeles, CA
POSTED
Today

Description 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 hourlyQualifications 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 investigationExperience in commercial and managed care collections, highly desiredAbility to interpret payer contracts and process contractual adjustmentsIn-depth knowledge of UB04 requirements and medical billing processesStrong analytical skills and proven proficiency in Excel and spreadsheetsUnderstanding 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 affiliationsExcellent verbal and written communication skillsProficiency in Microsoft Office, especially Excel and WordExceptional organizational skills, with the ability to meet deadlines, work independently or as part of a team, and prioritize tasks effectively#J-18808-Ljbffr

About the Company

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Academy of Managed Care Pharmacy