Medi-Cal & CCS Authorization / Collector

Join the transformative team at City of Hope , where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope's growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, andtreatment facilitiesin Atlanta, Chicago and Phoenix. our dedicated and compassionate employees are driven by a common mission: To deliver the cures of tomorrow to the people who need them today.

Position Summary:

To efficiently and collectively collect reimbursement for professional services rendered. The Collector is in charge of monitoring and processing accounts that are both straightforward or may need further research in order to bring resolution. The Collector will work with minimal supervision from management to ensure the integrity of the work performed. The Collector works in a team environment to fulfill the mission and goals of the Division.

As a successful candidate, you will:

• Follow-up all assigned accounts from within billing and accounts receivable system in accordance with pre-established goals.

• Initiates proactive measures that result in account resolution, including written and verbal claims, follow-up actions and first and second level appeals.

• Ensures all conditions for payment receipt have been satisfied, which includes; but not limited to:
  • Accurate charges
  • Patient insurance eligibility
  • Accurate financial class
  • Patient benefit coverage
  • Authorization/certification/TAR information
  • Patient responsibilities
  • Claims address
  • CPT coding, as applicable
  • ICD-9 coding, as applicable
• Responds timely and accurately to all incoming related correspondence and inquiries from payers, patients and other authorized parties. Reports any trends in incoming correspondence to managers for appropriate follow-up.

Your qualifications should include:

• High school diploma or equivalent.
• Minimum three (3) to five (5) years experience performing medical functions. Minimum experience including corresponding with patients and insurance companies in resolving patient accounts. Extensive knowledge of insurance carrier procedures.
• Experience with reading Explanation of Benefits (EOB) statements.
• Proven ability to handle multiple conflicting tasks.