HB Commercial Collector

About The Wilshire Group 

The Wilshire Group, a renowned boutique consulting firm in Los Angeles, specializes in revenue cycle optimization and fostering effective collaboration between operational and IT facets.  With a robust track record of aiding over 100 healthcare systems nationwide, our team thrives on professionalism, efficiency, and adaptability.

Our core values- professionalism, efficiency, and flexibility- underscore our commitment to creating an inclusive and dynamic workplace.  We embrace diverse narratives and believe in offering opportunities to exceptional individuals who bring their best to the table.

We are currently offering a contracted interim position at one of US News Best Hospitals 2022-23.  This position caters to top performers seeking a professional environment that acknowledges and values their dedication and proficiency.  While this role doesn’t offer benefits, it presents an opportunity to work within an organization that encourages talented individuals to surpass conventional boundaries.

Join us at The Wilshire Group, a place where talented professionals find a home to showcase their skills and contribute meaningfully to the healthcare landscape.

Why Wilshire? Employee Testimonial

“The number of RCM subject matter experts I get to work with each day is unreal.  Working alongside and as part of this team to help shape the RCM space is exciting.”-Patti Consolver, Director of Business Development 

This is a contracted position for 3-4 months.  This positions offers $25.00-$27.00 per hour.

Position Overview: We are seeking an experienced and detail-oriented Hospital Commercial Payer Collection Specialist with a minimum of 5 years of expertise in healthcare revenue cycle management, particularly focused on commercial payer collections. The ideal candidate will possess in-depth knowledge and hands-on experience working with the EMR Epic system. As a vital member of our finance team, the candidate will play a crucial role in optimizing revenue streams by ensuring accurate and timely collections from commercial payers.

Responsibilities:

1. Commercial Payer Collections:

• Manage and oversee the end-to-end process of commercial payer collections for hospital services.
• Analyze and resolve complex billing and reimbursement issues, ensuring maximum revenue recovery.

• Demonstrate proficiency and extensive experience in utilizing the EMR Epic system.
• Leverage Epic functionalities to streamline collection processes, identify trends, and optimize workflows.

• Conduct thorough reviews of denied claims and implement corrective actions to resolve issues promptly.

1. Reconciliation and Reporting:

• Reconcile payment discrepancies and discrepancies in accounts receivable related to commercial payer collections.

1. Contract Compliance:

• Ensure compliance with commercial payer contracts and fee schedules.
• Stay updated on changes in reimbursement policies and proactively adjust collection strategies accordingly.

• Collaborate effectively with billing teams, payers, and internal departments to resolve issues and streamline processes.
• Communicate regularly with stakeholders regarding collection performance and initiatives.

• Identify opportunities for process improvement and efficiency in commercial payer collections.
• Implement best practices to enhance overall revenue cycle performance.

Qualifications:

1. Education and Certification:

• High School
• Relevant certifications in revenue cycle management or healthcare finance preferred.

• Minimum of 5 years of experience in hospital commercial payer collections.
• Proven track record of success in optimizing revenue and reducing outstanding AR.

• Proficient in using the EMR Epic system for revenue cycle management.
• Advanced skills in Microsoft Excel and all other Microsoft relevant software applications.
• Must be able to work remotely, manage time effectively and meet production expectations of 40 accounts per day.
• Home office must be adequate, have operating internet service, with Wi-Fi, minimum Internet speed of 100 Mbps

• Strong analytical and problem-solving skills to address complex billing and reimbursement challenges.

• Excellent written and verbal communication skills with the ability to collaborate across departments.

• Ability to adapt to changes in payer policies, regulations, and healthcare industry trends.