Collector, Management Services Organization​/Centralized Billing Office - CBO

Join to apply for the Collector, Management Services Organization/Centralized Billing Office - CBO - Full Time 8 Hour Days (Non-Exempt) (Non-Union) role at Keck Medicine of USC
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The Collector Appeal Specialist is responsible for accurately processing inpatient and out‑patient claims to third‑party payers and private pays, following all mandated billing guidelines. Responsible for ensuring timely filing and guidelines are met; providing quality control checks on paper and electronic claims; processing tracers, denials and related correspondence; initiating appeals; composing and submitting appeal letters specific to challengeable denial issues consistent with the most recent American Medical Association Current Procedural Terminology.

Must demonstrate a positive demeanor, good verbal and written skills, and professionalism in both appearance and approach. Will maintain consistent productivity standards as appropriate for the unit and maintain an average of 90% (score 9.0) or better on Quality Reviews.

The Professional Billing Refund Collector is responsible for accurately reviewing credit balances and processing adjustments, transfers and refunds as needed. Helps in billing operations by providing support and research of misapplied payments. Works as a member of the billing team to provide smooth operational flow resulting in optimum customer (internal/external) satisfaction and effective/efficient processes.

Direct supervision required. Daily, weekly and/or monthly unit meetings may be required. Direct review of daily production and other production‑based reports to validate staff usage needs, portfolio reduction efforts, customer services and staff morale.

• Technical Duties
  • Billing Tasks:
    Analyze and determine which billing procedure should be followed, based upon the type of financial class, e.g., contracts, private insurance carrier, HMOs, government programs, Federal/State/Local and Self‑Pay accounts in conjunction with type of billing: transplants, grants, trauma and indigent programs, LOAs, MSP billing. Analyze the information submitted by the various departments for billing and the appropriate documentation required for processing a claim form whether submitted hard copy or electronically.
    
    Understand all billing vendors used by the MSO – CBO. Contact by telephone or e‑mail the appropriate departments to obtain the required information needed to process a claim. Analyze the pre‑printed information on the claim form(s) or billing system to ensure that it is accurate and consistent with other information contained in Cerner or patient accounting system and make corrections as necessary.
    
    Edit charges on the claim form(s) or billing system for which departmental and payer guidelines stipulate should not be billed to the sponsor. Recompute the total amount due prior to submitting the claim (e.g., edit unbillable charges for all payors). Review the claim forms to identify sensitive diagnosis information and follow guidelines and procedures established by the department to maintain patient confidentiality.
    
    Review charges/encounter forms for accurate billing information and assure that data fields are correct. Input all the required information needed to complete the claim, edit accordingly and submit either hard copy or electronically, with all the required documentation. Obtain and review the medical record or online reports for additional documentation to be attached to hard copy claim forms. Transmit claims via electronic vendor, once all corrections and adjustments have been processed.
    
    Submit completed claim forms to appropriate carriers with all required supplemental documentation. Submit hard copy claims via certified mail. Work and resolve rejects for all assigned claims daily. Bills for late charges as needed. Communicate identified billing issues and trends to supervisor and billing manager in a timely manner. Communicate issues with claim scrubber edits to supervisor and billing manager in a timely manner.
    
    Communicate issues that impact bill holds with outside vendors: e.g., CMRE/RSI Collection Agencies to reporting manager. Utilize CPT,…