Commercial Hospital Collections Representative

Title: Commercial Hospital Collections Representative

Job Description:

Work Location: Los Angeles, CA, USA

Onsite or Remote 

Flexible Hybrid

Work Schedule 

Monday-Friday; 7:00 AM - 4:00 PM

Salary Range: $27.65 - 39.27 Hourly

Employment Type 

2 - Staff: Career

Duration 

Indefinite

Job # 

32437

Primary Duties and Responsibilities

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As a Commercial 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

As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.