The Medical Collector / Accounts Receivable Representative is responsible for provider-side insurance collections, accounts receivable follow-up, denial resolution, reconsiderations, and appeals. This role requires advanced payer knowledge and the ability to independently research and resolve unpaid, underpaid, rejected, and denied claims through final resolution.
Key responsibilities include managing assigned insurance AR, following up on claims through payer portals and direct contact methods, preparing corrected claims and appeals, reviewing EOBs/ERAs and denial details, prioritizing aged and high-dollar accounts, documenting all account activity in the practice management system, identifying recurring payer issues, and meeting productivity and collection goals.
Experience
- Minimum 5 years of recent professional/provider-side medical collections and accounts receivable experience
Technical skills
- Extensive experience with Commercial insurance, Medicare, Medi-Cal/Medicaid, Medicare Advantage, Medi-Cal Managed Care, HMO, PPO, and other third-party payers
- Strong hands-on experience with claim reconsiderations, corrected claims, formal appeals, and complex denial resolution
- Working knowledge of CMS-1500 claims, CPT, HCPCS, ICD-10-CM, modifiers, place of service, NPI/taxonomy, COB, eligibility, authorizations, and timely filing requirements
- Ability to interpret EOBs, ERAs, payer correspondence, contractual adjustments, deductibles, copays, and coinsurance
- Experience with payer portals, clearinghouses, practice management systems, Microsoft Excel, Outlook, and Teams
Additional qualifications
- High school diploma or equivalent
- Strong attention to detail and accuracy
- Strong analytical, problem-solving, organizational, and time management skills
- Ability to work independently and collaboratively
- Effective written and verbal communication skills
- High level of accountability and professionalism
- Ability to maintain confidentiality and comply with HIPAA and company policies
- Ability to meet productivity standards and work flexible schedules
Benefits and perks
- Medical, dental, vision, life, and LTD insurance
- Eligibility for benefits may begin on the first of the month following hire
- 12 paid holidays, including 1 mental health day
- 401(k) retirement plan with possible employer match up to 4% after 90 days
- Flexible Spending Account (FSA)
- 40 hours of sick pay after 90 days
- 120 hours of PTO accrued within the first year
Location
Los Angeles, California, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
1 week ago