Description We are seeking a Collections Specialist to join our team in Costa Mesa, California. The role entails working with insurance companies, government payers, and patients for the resolution of payments and account resolution. This role involves a thorough understanding of the Revenue Cycle processes and an ability to interpret Explanation of Benefits (EOBs) and Electronic Admittance Advices (ERAs).

Responsibilities:

• Serve as the account representative, working closely with insurance companies, government payors, and patients to resolve payments and account issues.

• Evaluate claims at the contract rate with the use of the contract management tool for proper pricing.

• Initiate the initial appeal for underpayments while observing all timely requirements to secure due reimbursement.

• Review and complete payor and/or patient correspondence in a timely manner.

• Escalate to the payor and/or patient accounts that need to be appealed due to improper billing, coding, and/or underpayments.

• Report new/unknown billing edits to the direct supervisor for review and resolution.

• Interpret Explanation of Benefits (EOBs) and Electronic Admittance Advices (ERAs) to ensure proper payment as well as assist and educate patients and colleagues with an understanding of benefit plans.

• Demonstrate knowledge of and effectively use patient accounting systems.

• Document all calls and actions taken in the appropriate systems.

• Establish a payment arrangement when patients are unable to pay in full at the time payment is due. Requirements • Demonstrated expertise in Customer Service

• Proficiency in Documentation and Procedures

• Understanding of Policy and Payment Processing

• Experience with Cash Activity and Review

• Knowledge of Medical Coverage, Pricing, and Benefit Functions

• Familiarity with Billing and Collection Processes

• Ability to handle Correspondence and Claim Administration

• Experience with Clinical Trial Operations and Consumer Electronics

• Proficiency in Coding and Authorizations

• Understanding of Methodology

• Experience working with Insurance Companies and handling Reimbursements

• Knowledge of Medicare, Appeals, and Patient Account management

• Ability to work within the legal and ethical boundaries of the role

Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more.

All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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