Peregrine Team is seeking an experienced Collector III to join a leading healthcare organization. This role is responsible for resolving complex insurance and patient accounts, maximizing reimbursement, managing appeals, and serving as a resource to team members. The ideal candidate brings deep knowledge of hospital billing, managed care contracts, government payors, and revenue cycle operations.Location: Open to local candidates in Costa Mesa, CA (on-site) or remote candidates residing in Georgia, Iowa, Indiana, Missouri, Nebraska, North Carolina, Tennessee, Texas, Utah, Wisconsin, or Wyoming.Key Responsibilities:Manage and resolve complex insurance and patient accounts within assigned work queues.Analyze claims, payments, denials, and underpayments to ensure accurate reimbursement.Initiate and manage appeals while meeting all filing and timely appeal requirements.Interpret EOBs and ERAs to identify payment discrepancies and resolve outstanding balances.Research and resolve billing, coding, authorization, and reimbursement issues.Communicate effectively with insurance carriers, patients, and internal departments to facilitate account resolution.Document account activity, correspondence, and follow-up actions within patient accounting systems.Maintain a strong understanding of managed care contracts, reimbursement methodologies, and federal and state regulations.Serve as a resource for escalated account issues and complex reimbursement scenarios.Support onboarding and training of new team members.Identify opportunities for process improvement and recommend enhancements to workflows and procedures.Consistently meet or exceed productivity and quality standards.Participate in special projects and other duties as assigned.Required Qualifications:High school diploma or equivalent.5+ years of experience in hospital billing, healthcare collections, accounts receivable, or revenue cycle operations.Working knowledge of Epic Resolute, EpicCare, Epic CPOE, and reporting tools.Working knowledge of Microsoft Excel.Preferred Qualifications:Strong knowledge of commercial, managed care, and government payors, including Medicare, Medi-Cal, and Tricare.Experience managing denials, appeals, underpayments, and complex account resolution.Understanding of hospital billing practices, including UB-04 and HCFA-1500 claim forms.Strong analytical, organizational, and problem-solving skills.Excellent communication and customer service abilities.
