Experience Inc. Jobs

Description We are in search of a Medical Collections Specialist to join our team in the healthcare industry located in Irvine, California. This role offers a long-term contract employment opportunity and involves processing and following up on medical claims and invoices, maintaining customer care, and ensuring compliance with legal requirements.

Responsibilities:

• Proactively follow-up on the status of submitted medical claims and invoices, ensuring timely processing and resolution.

• Request medical records as necessary to support claims and invoice submissions.

• Prepare and submit medical appeals to insurance carriers, maintaining a systematic approach to follow-up on all submitted appeals.

• Cooperate with all departments across the organization to ensure smooth operations.

• Adhere to all applicable legal requirements such as CLIA, OIG in the collection of money from insurance companies, hospitals, and patients.

• Regularly contact insurance companies to follow up on claims and appeals that have been submitted but have not received payment or correspondence within the allotted time frame.

• Utilize skills in Accurint, Allscripts, Cerner Technologies, Dynamic Data Exchange (DDE), and EHR SYSTEM to efficiently process and follow up on patients for copays and deductible amounts due.

• Administer accounts receivable, appeals, billing functions, claim administration, and collection processes to maintain accurate customer credit records.

• Ensure an efficient customer service by resolving customer inquiries and maintaining accurate customer records.

• Monitor customer accounts and take appropriate action based on account activity. Requirements • Must possess proficiency in Accurint, Allscripts, Cerner Technologies, Dynamic Data Exchange (DDE), and EHR SYSTEM

• Demonstrable experience in Accounts Receivable (AR), Appeals, Billing Functions, Claim Administration, and Collection Processes

• Understanding of the healthcare industry, specifically within the NHS

• Strong communication and interpersonal skills to liaise with various stakeholders

• Detail-oriented and capable of maintaining accurate records

• Ability to work independently and as part of a team

• Exceptional organizational skills to manage multiple tasks and deadlines

• Knowledge of privacy regulations and medical terminologies

• Must handle patient information with confidentiality and discretion

• Problem-solving skills to address and resolve payment issues

• Ability to maintain professionalism and patience when dealing with challenging situations

• Computer literacy, including proficiency in Microsoft Office Suite

• Previous experience in a medical collections role would be advantageous.

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.

© 2024 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use (https://www.roberthalf.com/us/en/terms) .