This list contains only the countries for which job offers have been published in the selected language (e.g., in the French version, only job offers written in French are displayed, and in the English version, only those in English).
A Hospital in the San Fernando Valley are looking for an experienced Hospital Medical Collections Specialist. The Hospital Medical Collections Specialist ideal for someone with a strong background in medical revenue cycle activities and a solid understanding of payer follow-up across government and commercial plans. The Hospital Medical Collections Specialist will help drive timely reimbursement by resolving outstanding accounts, addressing denials, and working through appeals for both inpatient and outpatient hospital claims. The hospital is open to candidates with at least 2 years of experience.
Job Responsibility
Pursue payment on outstanding hospital accounts by conducting thorough follow-up with insurance carriers and other payers to secure accurate and timely reimbursement
Review inpatient and outpatient claims to identify billing issues, payment delays, denials, and underpayments, then take appropriate action to move accounts toward resolution
Manage collection activity across a range of payer types, including Medicare managed care, Medi-Cal managed care, commercial plans, and HMO or PPO coverage
Prepare and submit appeals, reconsiderations, and supporting documentation to challenge denied or incorrectly processed claims
Investigate account discrepancies by analyzing billing records, payer responses, and remittance details to determine the next steps for resolution
Coordinate with internal teams to correct claim information, resolve documentation gaps, and improve the collection of hospital receivables
Maintain detailed account notes and status updates to ensure clear documentation of collection efforts and payer communications
Requirements
At least 3 years of recent experience in hospital billing and medical collections
Hands-on knowledge of hospital revenue cycle processes, including claim follow-up, denial resolution, and appeals management
Experience working with multiple payer categories such as Medicare managed care, Medi-Cal managed care, and commercial insurance plans
Familiarity with HMO and PPO reimbursement structures in a hospital setting
Understanding of both inpatient and outpatient hospital accounts
Strong analytical skills with the ability to review account activity and identify barriers to payment
Effective communication and organizational skills to manage a high volume of accounts and payer interactions