Managed Care Billing Specialist

• Perform insurance collections follow-up on outstanding hospital claims with a focus on Medicare and Managed Care payers
• Review and work hospital UB04 claims to ensure accurate billing and proper reimbursement
• Investigate and resolve claim denials, rejections, underpayments, and payment delays
• Submit corrected claims, supporting documentation, and appeals as needed to facilitate payment resolution
• Follow up on aged accounts receivable and maintain productivity in line with departmental goals
• Document all collection activity, account updates, and payer communications in the billing system
• Collaborate with billing, coding, and patient financial services teams to resolve claim discrepancies and improve reimbursement outcomes
• Monitor payer trends and escalate recurring issues impacting collections

• At least 3 years of experience in medical insurance collections, insurance follow-up, or healthcare accounts receivable
• Prior hospital-based billing or collections experience is required
• Hands-on experience working with UB04 claims in a hospital environment
• Strong understanding of payer guidelines, reimbursement practices, and insurance follow-up procedures
• Background in denial resolution, appeals processing, and correction of claim-related issues
• Ability to manage a high-volume workload with strong accuracy, organization, and attention to detail
• Effective written and verbal communication skills with solid analytical and problem-solving ability
• Familiarity with hospital billing systems and electronic medical records is preferred

Familiarity with hospital billing systems and electronic medical records is preferred

• medical
• vision
• dental
• life and disability insurance
• company 401(k) plan