Medical Collector

Company: Agendia
Location: Irvine
Posted on: February 10, 2025

Job Description:

Description **Lucrative incentive opportunity ranging from $1,000-$9,000 per quarter
AIM OF THE POSITION:The Patient Advocate Representative (Collector) follows-up on the status of submitted claims and invoices; requests medical records as needed; prepares various medical appeals and the submissions of such appeals to insurance carriers; follows-up on all submitted medical appeals in a timely manner.
POSITION WITHIN THE ORGANIZATION:1. Customer Care, Sales, Commercial and external vendors2. Cooperates with all departments across the organization Requirements ESSENTIAL DUTIES AND RESPONSIBILITIES:* Collects money due from insurance companies, hospital and patients in compliance with CLIA, OIG and all other applicable legal requirements.

• Contacts insurance companies to follow up on claims and appeals which have been submitted, but no payment or correspondence received within the allotted time frame.
• Processes and follows up with patients for copays and deductible amounts due.
• Contacts clients to obtain medical records as needed for submission of a medical appeal or payer's review of a claim.
• Prepares custom appeal letters and letters of interest to various insurance carriers and managed care groups.
• Reviews files to determine if amounts should be written off based on acceptable reimbursement, then forwards these to the Reimbursement Manager.
• Investigates and prepares any necessary refund requests from payors for submission to the Reimbursement Manager.
• Negotiates reimbursement single settlements with various insurance carriers and third party administrators, based upon department guidelines.
• Interfaces with insurance company representatives, doctor's offices and hospitals regarding schedule of services and billing inquiries.
• Assists department director in the development of new procedures and systems to enhance productivity.
• Provides account information to the sales force as needed.The above listing represents the general duties considered essential functions of the job and is not to be considered a detailed description of all the work requirements that may be inherent in the position.
  KEY CONTACTS:* Internal: This position may interface with all departments within the company.* External: External Vendors
  EDUCATION AND EXPERIENCE REQUIREMENTS:EDUCATIONEducation:* High school diploma or general education degree* 3+ years related experience
  KNOWLEDGE, SKILLS AND ABILITIES (KSA'S):
  Specific Knowledge Required:Knowledge: Comprehension of a body of information acquired by experience or study.Skill: A present, observable competence to perform a learned activity.Ability: Competence to perform an observable behavior.* Advanced technical knowledge of Microsoft products required (Excel, Word, Outlook)* Must be able to work in a fast-paced environment* Must have strong organizational skills and attention to detail* High degree of accuracy* Manage multiple tasks independently* Other skills necessary are accounting, data entry, general math, analytical, thoroughness, research, verbal/written communication
  BEHAVIOURAL COMPETENCIES/DESIRED SKILLS:* Excellent problem resolution* Excellent customer service skills* Outside-the-box thinker
  * PRIVACY NOTICE: To review the California privacy notice, click here:
  * Employees must not be classified as an excluded individual who is prohibited from participation in any Federal health care program.
  WORKING ENVIRONMENT:Establishes ADA (Americans with Disabilities Act) requirements
  ENVIRONMENT/SAFETY/WORK CONDITIONS:Working conditions (inside or outside the office)* General office environment. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.* Maintains a clean, neat, and orderly work area.* Adheres to Department Specific Safety Guidelines.* Standing, sitting, walking, bending, reaching, manual manipulation, and lifting up to 15 pounds.
  TRAVEL:No travel is required.
  OTHER DUTIES:Other duties as required by management Salary Description $24.00-$27.00 per hour Required
  Preferred

  Job Industries

  • Other

Keywords: Agendia, Irvine , Medical Collector, Healthcare , Irvine, California