Medical Collections Specialist
Core
Manage assigned payer accounts, follow up on outstanding claims, and resolve denials, underpayments, and unpaid balances to support timely insurance reimbursement.
Role type
Medical Collections Specialist
Builds
Revenue cycle operations for a patient-focused healthcare organization
Domain
Healthcare / Medical Billing
Deliverable
client delivery
Required skills
Medical collections, Insurance claim investigation, Payer contract interpretation, Healthcare billing systems, Data entry, Compliance training
Preferred skills
Home infusion billing, Specialty pharmacy billing, Revenue-cycle management systems
Responsibilities
Follow up on submitted insurance claims, Manage assigned payer accounts, Investigate denied and underpaid claims, Communicate directly with insurance payers, Review claims for corrections or appeals, Interpret payer contracts, Collaborate with billing and pharmacy teams, Respond to inquiries regarding claim status, Maintain accurate documentation of communications, Stay informed about medical billing regulations, Use healthcare billing systems and clearinghouses, Assist with reporting and data entry
Seniority
Mid-level, individual contributor