Senior Collections Representative (Credit Balance)

Patient Business Services

Join a team dedicated to financial integrity and operational excellence at UCLA Health. As a Senior Collections Representative (Credit Balance) in our Patient Business Services department, you will bring advanced expertise to the resolution of complex, high-dollar, and aged credit balance accounts. This role is central to protecting revenue accuracy and ensuring compliance across payer types, while serving as a subject matter resource for colleagues and cross-functional partners.

In this role, you will:

• Reviewing inpatient and outpatient claims/balances to ensure maximum collection dollars by providing appropriate follow-up and documenting actions taken.
• Investigate and resolve complex, aged, and high-value credit balances, including the processing of refunds and adjustments across all liability categories, regardless of service line. Manage and respond to written correspondence and maintain a high volume of telephone communication to ensure timely follow-up, accurate account resolution, and adherence to organizational standards.
• Analyze root causes including duplicate payments, coordination of benefits errors, and contractual discrepancies, and document detailed findings and actions within patient accounting systems.
• Following refund and reimbursement procedures and, after researching credit balances.
• Prepare and process refund packets.

Salary Range: $33.27 - $47.77 hourly

We're seeking an experienced revenue cycle professional with:

Required

• High school diploma or equivalent combination of education and experience.
• Minimum of 5 years of experience in hospital billing, collections, or credit balance resolution.
• Advanced knowledge of billing and collections processes across payer types.
• Ability to interpret payer contracts and negotiate resolution within contractual guidelines.
• Skill in evaluating complex account data and identifying systemic issues.
• Knowledge of healthcare regulations and confidentiality requirements, including HIPAA.
• Proficiency with patient accounting and billing systems.
• Strong written communication skills for documenting complex account findings.
• Ability to collaborate effectively across departments to resolve complex issues.
• Proficiency in Excel and analytical tools for data review and reporting.

Preferred

• Familiarity with medical terminology and coding concepts.