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Healthcare Job in Los Angeles, California : CA 90005

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Healthcare Collections Specialist

APLA HealthLogo
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APLA Health
Finance
611 South Kingsley Drive
Los Angeles
California
90005
click here to apply

Healthcare Collections Specialist Job Description

 

APLA Health’s mission is to achieve health care equity and promote well-being for the LGBT and other underserved communities and people living with and affected by HIV. We are a nonprofit, federally qualified health center serving more than 14,000 people annually. We provide 20 different services from 15 locations throughout Los Angeles County, including: medical, dental, and behavioral health care; PrEP counseling and management; health education and HIV prevention; and STD screening and treatment. For people living with HIV, we offer housing support; benefits counseling; home health care; and the Vance North Necessities of Life Program food pantries; among several other critically needed services. Additionally, we are leaders in advocating for policy and legislation that positively impacts the LGBT and HIV communities, provide capacity-building assistance to health departments across the country, and conduct community-based research on issues affecting the communities we serve. For more information, please visit us at aplahealth.org.


APLA Health is currently seeking a Healthcare Collections Specialist to join our Los Angeles team!

We offer great benefits, competitive pay, and great working environment! This is a great opportunity to make a difference!


POSITION SUMMARY:

The Healthcare Collections Specialist is responsible for timely and appropriate collections of payments from patients and third party payers. 

 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Achieve and maintain days in A/R at best in class standards

Work daily denials and resubmit claims as appropriate

Work and submit all levels of appeals

Post payments

Follow-up with insurance carriers on unpaid claims until paid by correcting billing errors and resubmitting claims, contacting patients, contacting insurance plans, determining if a claim is a hardship case and what classification code or description should be assigned

Submit and follow-up on patient monthly statements

Evaluate accounts to determine any write-offs or corrections required, including duplicate charges

Research patient inquiries regarding services by confirming charges and encounters in the EMR

Compile and generate reports as directed

Ensure that all conditions for payment receipt have been satisfied, including but not limited to: accurate charges and financial class; authorization/certification information; demographic and insurance information; ICD-10 and CPT-4 coding; patient insurance eligibility and benefit coverage.

Assist with month-end and year-end close.

Stay informed of changes in contracts, billing requirements and insurance types within area of responsibility; maintain knowledge of publicly funded programs, grants and third party insurance contracts including My Health LA, Medicare, Medi-Cal, managed care plans, PPOs, and HMOs. Stay current with legal and regulatory changes, and local and national trends, in coding.

Understand and apply the Sliding Fee Discount Program as appropriate.

Maintain current working knowledge of eClinicalWorks billing module.

Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations.

 

OTHER DUTIES MAY BE ASSIGNED TO MEET BUSINESS NEEDS.

 


Los Angeles Healthcare Job

Healthcare Collections Specialist Job Requirements

REQUIREMENTS:

Training and Experience:

High school diploma or GED required; Certified Professional Biller preferred but not required. Must have at least three years of direct healthcare claims collection experience, using the practice management system of an electronic health system. Federally Qualified Health Center billing experiences a plus. Experience with eClinicalWorks or a similar electronic health record preferred (will train on eCW). Bilingual (English and Spanish) preferred.

Knowledge of:

CPT, CDT, HCPCS and ICD-10 coding protocols, Medi-Cal, Medicare, managed care and private insurance billing, claim adjustment reason Codes, and remittance advice remark codes. Understanding of insurance guidelines regarding claim and authorization submission, reimbursement methods and claims appeal process. Knowledge of FQHC billing protocols. Must be proficient in the use of Microsoft Office programs. Experience with professional and UB-04 claim forms.

Ability to:

Communicate effectively with providers, other staff, and outside vendors. Must be well organized and detail oriented. Must have excellent denial management skills, a high level of accuracy and attention to detail, and possess strong organizational skills.

WORKING CONDITIONS/PHYSICAL REQUIREMENTS:

This is primarily an office position that requires only occasional bending, reaching, stooping, lifting and moving of office materials weighing 25 pounds or less. The position requires daily use of a personal computer and requires entering, viewing, and revising text and graphics on the computer terminal and on paper.

An Equal Opportunity Employer.


Benefits:

As member of our team of professionals you will receive:

403b with company match

Medical, dental, vision insurance

Paid time-off

Life insurance

Access to an Employee Assistance Programs

Paid Parking / or METRO reimbursement

And much more!


To Apply:

Visit our website at www.aplahealth.org to apply or click the link below:

https://www.paycomonline.net/v4/ats/web.php/jobs/ViewJobDetails?clientkey=A5559163F67395E0A2585D2135F98806&jpt=&job=27384

Apply to this Los Angeles Healthcare Job
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