ResponsibilitiesAs the Medicare Collector for the medical group, you will be responsible for:* Accurately processing inpatient and outpatient claims to government and commercial payers, following all mandated billing guidelines* Provide quality control checks of denied claims, the ability to process tracers, process contractual adjustments and allocation of funds; initiate appeals* Draft, compose, and submit appeal letters specific to coding issues consistent with the most updated American Medical Association Current Procedural Terminology* Perform all required duties within the patient accounting systems* Overturn denials and secure payment of denied claims.QualificationsWe’re seeking a detail-oriented, self-directed professional with:* Two years recent professional medical collection experience, preferably experience with Medicare* Skill in drafting appeals, identifying denial reason and ability to secure payment of denied claims* Knowledge of commercial contracts, with the ability to understand contract language in order to appeal denied claims and/or secure underpayments* Knowledge of how to use modifiers to secure payment, i.e.
25, 33, 59 and 51* Working experience with Medi-Cal, Medicare, HMO, and PPO insurance* Experience using on line payer sites with the ability to check claim status, denials, and eligibility* Knowledge of MS Word and MS Excel software* Knowledge of CPT, ICD-10, and HCPC codes* Must be an effective multi-tasker in order to meet daily production and quality standardsUCLA is an Equal Opportunity/Affirmative Action employer.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.