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Job Details

UCLA Health Systems

Medi-Cal FFS Collections Representative



Full Time

On Site


Los Angeles, California, United States


As a Medi-Cal FFS Collections Representative, you will be responsible for:

* Reviewing Medi-Cal Fee for Service (FFS) credit balances, validate Medi-Cal credit balances, post adjustments, and request transfer of incorrect applied payments to the appropriate account and/or liability bucket

* Review Medi-Cal RA's in a timely manner so the account is expedited through the collection flow

* Review assigned inpatient and outpatient claims to ensure maximum collection dollars were paid

* Managing a portfolio of assigned accounts, responding to correspondence, and heavy telephone contact to ensure timely follow-up and account resolution, and some Customer Service phone coverage

* Performing all necessary duties in the Patient Accounting Systems

* Productivity Standards of 35 accounts per day/175 accounts per week and Quality Standards must be met


We are seeking a seeking a detail-oriented, self-directed professional with:

* Three or more years of collections experience within a hospital setting, with strong emphasis on Medi-Cal Fee for Service appeals/underpayment collections

* Strong analytical skills, proficient with spreadsheets

* Knowledge of collection techniques and collection laws (i.e. AB1455, Knox-Keene Act, Health & Safety Codes, etc.)

* Knowledge of medical terminology and CTP/HCPS codes

* Knowledge of networks, IPA's, HMO's, PPO's and PCP's and contract affiliations

* Ability to interpret payer contracts and processing contractual adjustments

* Strong written and verbal communication skills to interact diplomatically with our customers

* Skill in Microsoft Office Suite, including Excel and Word

* Proficient in meeting deadlines and ability to work independently and as a part of a team

UCLA is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.

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