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Collections Representative
Ref No.: 18-03159
Location: Emeryville, California
The Government, Commercial, Contract and Managed Care (CCMC) Units are responsible for the accounts receivable, billing, and follow-up of all government or commercial, contract and managed care payers.  The units deal regularly with complex policy and procedural issues that involve contract compliance with regard to Medicare, Medi-Cal, CCS, HMO and PPO payers.  It is the units' responsibilities to communicate and to coordinate throughout various Medical Center departments, including the billing agents to ensure the quality of the university's billing process. Within these units, the Follow-Up Representatives are responsible for billing and follow-up of government, commercial, contract and/or managed care accounts receivables for MGBS clients.  The incumbent demonstrates the ability to perform all aspect of billing and follow-up with quality.  The incumbent's main task is to resolve all outstanding insurance accounts through constant communication with the payers (by phone or via web access), other MGBS units, clinical departments and billing agents. When resolving the accounts receivables; the Follow-Up Representative must adhere to the MGBS SRG (Situation Response Guide) to ensure consistency with the follow-up and documentation processes and to maintain good quality work.  The Follow-up Representative must meet minimum productivity standards and quality expectations of their units.  The Follow-up Representative must attend and be engaged in unit and team meetings aimed at increasing knowledge.  The incumbent will utilize web based tools, including payor websites and the RMS website prior to calling payors. The incumbent will conform to all MGBS, government and HIPAA policies and procedures.

·         This position requires flexibility to orient and work at all Client Medical Center locations.
  • At least 1 year of previous Insurance Follow up experience.
  • Demonstrate the Ability to communicate effectively (orally and written).
  • Knowledge of CPT / ICD-9 or ICD-10
  • Experience With Denials Management
  • Experience with MS EXCEL and OUTLOOK.