As a Medical Collector, you will have the opportunity to achieve sales goals and objectives for our innovative products. Collaborate with Supervisors, Sales Management, and Distributors to expand business and support customers with insurance reimbursement and alternative funding solutions.

Responsibilities:

• Become a subject matter expert in insurance processes, including utilization management, pre-certifications/authorizations, referral authorizations, and pre-service appeals.

• Review and interpret medical documentation to understand patient history, diagnosis, and treatment plans.

• Determine medical necessity and clinical appropriateness for our products using payer-approved criteria.

• Submit demographic and clinical documentation to avoid delays in patient treatment.

• Collaborate with the field sales team and healthcare professionals to obtain necessary information for insurance submissions and appeals.

• Prepare and submit appeals on behalf of patients, addressing payer denials.

• Work with the Director of Inside Sales and Supervisors to develop business plans and exceed financial sales and marketing objectives.

• Utilize CRM and Call Center applications to manage your book of business accurately.

• Leverage information technology and programs to meet or exceed sales targets.

• Build relationships with insurance providers, alternative funding sources, government payers, and Care Credit to enhance win rates.

• Handle inbound and outbound calls with professionalism and proactive client service skills.

Education & Experience (Knowledge, Skills & Abilities):

• BS degree preferred and/or relevant experience.

• A minimum of 2 years of recent medical authorization experience, including medical record review.

• A minimum of 2 years of recent medical collections, insurance follow up, patient collections, and pre-service appeals.

• Industry experience with products not consistently reimbursed is preferred.

• Knowledge of medical terminology and ICD-10 coding; medical coding certification preferred.

• Experience in the medical industry, such as pharmaceutical, biotech, or durable medical equipment (DME).

• A minimum of 2 years of hands-on experience with CRM, Call Center software, and Microsoft 365.

• Candidate must have deep knowledge of insurance processes including utilization management, pre-certifications/authorizations (provider or insurance carrier), referral authorizations and pre-service appeals.

Onsite Valencia, CA 91355 Monday to Friday . opportunity to start 7am or 8am

Salary: $56K/yr. Base, plus commission (30K/yr.+ potential)

• Savings & Retirement 401(k) plan

• Time Away PTO, sick days, holidays

• Healthcare Programs PPO & HMO medical options, dental and vision

• HSA, Short-Term and Long-Term disability | Life and AD&D coverage

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

• The California Fair Chance Act
• Los Angeles City Fair Chance Ordinance
• Los Angeles County Fair Chance Ordinance for Employers
• San Francisco Fair Chance Ordinance