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NPH Medi-Cal Collections Representative

UCLA Health

Los Angeles, CAJob$29.03–41.23/hrSeen 6 days agoSeen in employer's feed 6 days ago

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At a glance

Compensation
$29.03–41.23/hr
Location
Los Angeles, CA
Work Authorization
Not specified

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Job overview

The Medi-Cal Fee For Service Collections Representative manages a portfolio of inpatient and outpatient claims and works to collect outstanding balances. The role involves reviewing accounts, communicating with third-party payers, patients, and internal departments, and following up on claims to resolve reimbursement discrepancies and payment issues. UCLA Health seeks a self-directed, detail-oriented candidate with relevant collections experience and knowledge of medical billing.

Skills & qualifications

RequiredNice to have

Skills

Medi-Cal Fee for Service CollectionsMedi-Cal Managed Care CollectionsPayer Contract InterpretationContractual AdjustmentsUB04 RequirementsMedical BillingAnalytical SkillsExcelSpreadsheet ProficiencyCollection TechniquesCollection LawsMedical TerminologyCPT CodesHCPCS CodesHealth NetworksIPAsHMOsPPOsPCPsContract AffiliationsVerbal CommunicationWritten CommunicationMicrosoft OfficeWordOrganizational SkillsDeadline ManagementIndependent WorkTeamworkTask Prioritization

Qualifications

High School Diploma or GED3+ Years Relevant Experience1+ Year Collections Investigation

Full job description

Description

Patient Business Services

As a Medi-Cal Fee For Service Collections Representative,

you will manage a designated portfolio of inpatient and outpatient claims,

ensuring effective and efficient collection efforts. Your primary

responsibilities include:

  • Conducting regular account reviews to identify outstanding balances.

  • Initiating and maintaining communication with third-party payers to resolve reimbursement discrepancies.

  • Diligently following up on claims to ensure timely resolution.

  • Communicate with insurance providers, patients, and internal departments to gather necessary information and resolve payment issues.

Salary Range: $29.03- $41.23/hourly

Qualifications

We are seeking a self-directed, detail-oriented individual

with:

  • High school diploma or GED; Minimum of 3 years of relevant experience, including at least 1 year in collections investigation

  • Experience in Medi-Cal Fee For Service and Medi-Cal managed care collections, highly desired

  • Ability to interpret payer contracts and process contractual adjustments

  • In-depth knowledge of UB04 requirements and medical billing processes

  • Strong analytical skills and proven proficiency in Excel and spreadsheets

  • Understanding of collection techniques and laws, including AB1455, the Knox-Keene Act, Health & Safety Codes, etc., Familiarity with medical terminology, CPT codes, HCPCS codes, health networks, IPAs, HMOs, PPOs, PCPs, and contract affiliations

  • Excellent verbal and written communication skills

  • Proficiency in Microsoft Office, especially Excel and Word

Exceptional organizational skills, with the

ability to meet deadlines, work independently or as part of a team, and

prioritize tasks effectively

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.

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