St. John's Community Health
Medical Collector I
St. John's Community Health, Los Angeles, California, United States, 90079
Medical Collector I
St. John's Community Health
Pay and Compensation
Base pay range: $30.00/hr – $35.00/hr
The Medical Collector I is a full‑time position responsible for managing denials and collecting outstanding account receivables, securing payment of denied claims for Medical, Dental, Optometry, Behavioral Health, OB‑GYN, and Podiatry claims. This is a challenging and rewarding position that requires strong communication skills, attention to detail, and the ability to work in a fast‑paced environment. This position reports to the Billing Manager; in some cases the focus may be on either coding or billing, but the employee must be cross‑trained in both.
Benefits
Free Medical, Dental & Vision
13 Paid Holidays + PTO
403(b) retirement match
Life Insurance, EAP
Tuition Reimbursement
Flexible Spending Account
Continued workforce development & training
Succession plans & growth within
Qualifications & Licensure Education, Experience, & Knowledge
Three (3) years of experience with revenue cycle operations management with excellent presentation and writing skills.
Advanced skills in analysis and MS Office suite.
eClinical Works experience is preferred.
High School diploma or GED required.
Billing Certification required.
Demonstrated knowledge of all Insurance companies, HMO’s, PPO’s, Government and State programs Medi‑Cal and Medicare, and third‑party payers.
Experience with managing revenue cycle processes including Medicaid and Medi‑Cal eligibility, health information management and billing, and charge capture processes.
Responsibilities
The billing department encompasses medical coding, charge entry, claims submissions, payment posting, accounts receivable follow‑up, and reimbursement management.
Works through patient insurance documentation, billing and collections, and data processing to ensure accurate billing and efficient account collection.
Analyzes billing and claims for accuracy and completeness; submits claims to proper insurance entities and follows up on any issues.
Follows up on claims using various systems, such as eClinical Works, Claim Remedi clearinghouse, Medicare DDE, Online payer sites, etc.
Maintains contacts with other departments to obtain and analyze patient information to document and process billings.
Analyzes trends impacting charges, coding, collection, and accounts receivable.
Successfully scrubs and quality controls claims prior to submission.
Works the A/R, works rejected claims, and provides necessary follow‑up to ensure successful claim processing.
Generates month‑end close patient financial communication letters and statements.
Provides quality control checks of denied claims, the ability to process tracers, process contractual adjustments and allocation of funds; initiates appeals.
Evaluates remittance to ensure accuracy and analysis of CAS and denial codes.
Maintains strong attention to detail and ability to multi‑task.
Maintains extremely high standards of professional conduct.
Establishes and maintains effective working relationships with the office staff and doctors.
Adheres to policies regarding safety, confidentiality, and HIPAA guidelines.
Ensures that the activities of the collection operations are conducted in a manner that is consistent with overall department protocol and are in compliance with Federal, State, and payer regulations, guidelines, and requirements.
Serves as a practice expert and go‑to person for denials questions and advice.
Performs other job duties as assigned.
Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function & Industry Accounting/Auditing and Finance; Hospitals and Health Care
St. John’s Community Health is an Equal Employment Opportunity Employer.
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Pay and Compensation
Base pay range: $30.00/hr – $35.00/hr
The Medical Collector I is a full‑time position responsible for managing denials and collecting outstanding account receivables, securing payment of denied claims for Medical, Dental, Optometry, Behavioral Health, OB‑GYN, and Podiatry claims. This is a challenging and rewarding position that requires strong communication skills, attention to detail, and the ability to work in a fast‑paced environment. This position reports to the Billing Manager; in some cases the focus may be on either coding or billing, but the employee must be cross‑trained in both.
Benefits
Free Medical, Dental & Vision
13 Paid Holidays + PTO
403(b) retirement match
Life Insurance, EAP
Tuition Reimbursement
Flexible Spending Account
Continued workforce development & training
Succession plans & growth within
Qualifications & Licensure Education, Experience, & Knowledge
Three (3) years of experience with revenue cycle operations management with excellent presentation and writing skills.
Advanced skills in analysis and MS Office suite.
eClinical Works experience is preferred.
High School diploma or GED required.
Billing Certification required.
Demonstrated knowledge of all Insurance companies, HMO’s, PPO’s, Government and State programs Medi‑Cal and Medicare, and third‑party payers.
Experience with managing revenue cycle processes including Medicaid and Medi‑Cal eligibility, health information management and billing, and charge capture processes.
Responsibilities
The billing department encompasses medical coding, charge entry, claims submissions, payment posting, accounts receivable follow‑up, and reimbursement management.
Works through patient insurance documentation, billing and collections, and data processing to ensure accurate billing and efficient account collection.
Analyzes billing and claims for accuracy and completeness; submits claims to proper insurance entities and follows up on any issues.
Follows up on claims using various systems, such as eClinical Works, Claim Remedi clearinghouse, Medicare DDE, Online payer sites, etc.
Maintains contacts with other departments to obtain and analyze patient information to document and process billings.
Analyzes trends impacting charges, coding, collection, and accounts receivable.
Successfully scrubs and quality controls claims prior to submission.
Works the A/R, works rejected claims, and provides necessary follow‑up to ensure successful claim processing.
Generates month‑end close patient financial communication letters and statements.
Provides quality control checks of denied claims, the ability to process tracers, process contractual adjustments and allocation of funds; initiates appeals.
Evaluates remittance to ensure accuracy and analysis of CAS and denial codes.
Maintains strong attention to detail and ability to multi‑task.
Maintains extremely high standards of professional conduct.
Establishes and maintains effective working relationships with the office staff and doctors.
Adheres to policies regarding safety, confidentiality, and HIPAA guidelines.
Ensures that the activities of the collection operations are conducted in a manner that is consistent with overall department protocol and are in compliance with Federal, State, and payer regulations, guidelines, and requirements.
Serves as a practice expert and go‑to person for denials questions and advice.
Performs other job duties as assigned.
Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function & Industry Accounting/Auditing and Finance; Hospitals and Health Care
St. John’s Community Health is an Equal Employment Opportunity Employer.
#J-18808-Ljbffr