Medical Collections Specialist
New
J
JobgetherHealthcare revenue cycle
Fully remote position within the United States., Monday-to-Friday, 8:00 AM to 4:30 PM CST.Full-TimeMiddle
Salary26 - 28 USD per hour
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Job Details
- Experience
- At least 3 years of medical collections or related revenue-cycle experience. Preferred: 5 or more years of medical collections experience.
- Required Skills
- Microsoft ExcelPowerPoint
Requirements
- High school diploma or GED.
- At least 3 years of medical collections or related revenue-cycle experience.
- Experience communicating with insurance payers and resolving outstanding medical claims.
- Experience providing professional customer service to internal and external stakeholders.
- Basic proficiency in Microsoft Word, Excel, and PowerPoint.
- Strong analytical and problem-solving abilities for investigating claim issues and identifying solutions.
- Attention to detail, organizational skills, and commitment to accurate documentation.
- Ability to prioritize competing demands and manage multiple tasks in a fast-paced, metrics-driven environment.
- Preferred: 5 or more years of medical collections experience.
- Preferred: Experience in home infusion, specialty pharmacy, or infusion therapy billing and collections.
- Preferred: Experience handling insurance denials, underpayments, appeals, and payer follow-up.
- Preferred: Familiarity with healthcare billing platforms, clearinghouses, and revenue-cycle management systems.
Responsibilities
- Follow up on submitted insurance claims and manage assigned payer accounts through resolution.
- Investigate denied, underpaid, and unpaid claims to identify causes and corrective actions.
- Communicate with insurance payers to resolve discrepancies, outstanding issues, and reimbursement delays.
- Review claims to determine whether they require correction, reconsideration, appeal, or rebilling.
- Interpret payer contracts, coverage requirements, and reimbursement methodologies to guide collection activities.
- Collaborate with billing, pharmacy, and operations teams to resolve reimbursement issues and improve collections workflows.
- Respond to inquiries about claim status and collection activity, and maintain accurate documentation of communications and resolutions.
- Use healthcare billing systems and clearinghouses to monitor claims and support collections.
- Assist with reporting, data entry, and other revenue-cycle activities.
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