Job Description
Job Description
We are seeking an experienced Medical Collections Specialist / Revenue Cycle Specialist to manage outstanding accounts receivable, follow up on unpaid claims, and ensure timely reimbursement from insurance carriers and patients.
This role is critical to maintaining cash flow and requires strong knowledge of insurance processes, denial management, and payer communication.
Key Responsibilities
- Follow up on outstanding insurance claims (Medicare, commercial, and secondary payers)
- Work denied or underpaid claims and initiate appeals when necessary
- Contact insurance companies via phone portals and online systems
- Analyze Explanation of Benefits (EOBs) and Remittance Advice (ERA)
- Resolve billing discrepancies and payment issues
- Maintain accurate documentation of all follow-up activity
- Communicate with internal team regarding account status
- Meet productivity and collection targets
Qualifications
- Minimum 2+ years of medical collections or revenue cycle experience
- Strong knowledge of:
- Medicare guidelines
- Commercial insurance billing
- Denial management and appeals
- Experience with EMRs such as:
- Office Ally, MD Suite, or similar systems
- Ability to read and interpret EOBs/ERAs
- Strong phone communication and follow-up skills
- Detail-oriented and highly organized
Preferred (Not Required)
- Experience with specialty billing (wound care, surgical, etc.)
- Knowledge of Medicare audits or compliance
- Certification (CPB, CPC, etc.)