Responsibilities
As a Medi-Cal FFS Collections Representative, you will be responsible for:
Reviewing Medi-Cal Fee for Service (FFS) credit balances, validate Medi-Cal credit balances, post adjustments, and request transfer of incorrect applied payments to the appropriate account and/or liability bucket
Review Medi-Cal RAs in a timely manner so the account is expedited through the collection flow
Review assigned inpatient and outpatient claims to ensure maximum collection dollars were paid
Managing a portfolio of assigned accounts, responding to correspondence, and heavy telephone contact to ensure timely follow-up and account resolution, and some Customer Service phone coverage
Performing all necessary duties in the Patient Accounting Systems
Productivity Standards of 35 accounts per day/175 accounts per week and Quality Standards must be met
Qualifications
We are seeking a seeking a detail-oriented, self-directed professional with:
Three or more years of collections experience within a hospital setting, with strong emphasis on Medi-Cal Fee for Service appeals/underpayment collections
Strong analytical skills, proficient with spreadsheets
Knowledge of collection techniques and collection laws (i.e.
AB1455, Knox-Keene Act, Health & Safety Codes, etc.)
Knowledge of medical terminology and CTP/HCPS codes
Knowledge of networks, IPA’s, HMO’s, PPO’s and PCP’s and contract affiliations
Ability to interpret payer contracts and processing contractual adjustments
Strong written and verbal communication skills to interact diplomatically with our customers
Skill in Microsoft Office Suite, including Excel and Word
Proficient in meeting deadlines and ability to work independently and as a part of a team
UCLA 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.