Medical Collections Representative Job at Robert Half (McKinney)

New

Billing & Collections Representative II

Under the direction of the Manager Professional Billing & Coding, the Billing & ...

Location

United States , San Diego

Salary:

Not provided

Rady Children's Hospital-San Diego

Expiration Date

Until further notice

Requirements

H.S. Diploma,GED,or Equivalent
2 Years of Experience
Must possess some medical billing experience

Job Responsibility

Resolution of all outstanding balances from all payors, including Commercial, Medi-Cal and Managed Care professional claims
Checking status of unpaid claims by telephone, websites and/or any other means available
Providing all necessary documentation required from payors to ensure accurate adjudication of claim for reimbursement
Processing claims correctly following contractual arrangements the Medical Practice Foundation (MPF) has with each Payor
Accurately analyzing each denial received by reviewing the patient acct, the remittance codes from Explanation of Benefits (EOB) and Remittance Advice (RA)
Reviewing CCI or payor specific coding edits and taking necessary steps to send a corrected claim or appeal to payor for reprocessing of claim to overturn denial
Reporting all problematic payor trends to leadership with specific examples
Daily processing of assigned work queues following standards established by Leadership
Reviewing payor/clearing house rejections and making necessary corrections to ensure claim will be adjudicated
Following federal, state, and local regulatory collection guidelines as well as department and payor specific billing guidelines

What we offer

Medical, Dental, Vision, Life, Pet insurance
Retirement Plan
Tuition Assistance
Wellness program

Fulltime

New

Medical Collections Specialist

We are looking for a Medical Collections Specialist to join a healthcare team in...

Location

United States , Sacramento

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Experience in medical collections, accounts receivable follow-up, or healthcare reimbursement functions
Strong understanding of Explanation of Benefits documents and insurance claim adjudication processes
Knowledge of patient financial responsibility concepts, including copays, deductibles, coinsurance, and out-of-pocket maximums
Familiarity with commercial insurance plans, PPO products, and Medicare Advantage reimbursement structures
Proven ability to write effective appeals for denied or underpaid medical claims
Confidence interacting with both insurance representatives and patients regarding account balances and claim outcomes
Ability to manage a high-volume workload, stay organized under pressure, and consistently achieve performance targets
Working knowledge of medical terminology and revenue cycle processes related to claim denials and reimbursement

Job Responsibility

Review payer contracts and reimbursement terms to determine correct allowed amounts and identify underpayments
Interpret Explanation of Benefits statements to evaluate claim decisions and confirm financial responsibility
Investigate denied, delayed, or partially paid claims and take appropriate action to secure proper reimbursement
Prepare clear, persuasive appeals that address payer findings and support claim reconsideration
Communicate with insurance carriers to resolve billing discrepancies, payment issues, and adjudication concerns
Speak with patients regarding outstanding balances, explaining how copays, deductibles, coinsurance, and out-of-pocket limits affect what they owe
Maintain consistent follow-up on assigned accounts while meeting productivity expectations in a fast-moving workload
Apply analytical judgment to determine the most effective next steps for account resolution and escalation when needed
Collaborate with team members to support collection goals and maintain quality standards across account follow-up activities

What we offer

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

Medical Collections Specialist

We are looking for a skilled Medical Collections Specialist to join our team in ...

Location

United States , Sacramento

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Proven experience in medical collections and healthcare revenue cycle management
Strong knowledge of medical terminology and insurance processes, including copay, coinsurance, and deductibles
Familiarity with Medicare Advantage plans and other insurance products
Demonstrated ability to write persuasive appeals for denied claims
Excellent communication skills for interacting with patients and insurance representatives
Ability to thrive in a fast-paced environment while maintaining accuracy and productivity
Strong analytical and problem-solving skills to address claim issues effectively
Commitment to teamwork and achieving organizational goals

Job Responsibility

Review and interpret contracts to identify allowed amounts and ensure proper claim adjudication
Analyze Explanation of Benefits (EOBs) to verify payment accuracy and patient liability
Communicate effectively with insurance companies to dispute denied or underpaid claims, ensuring resolution
Provide clear explanations to patients regarding their balances, claim outcomes, and financial responsibilities
Draft compelling appeals to challenge claim denials and secure appropriate reimbursements
Maintain a thorough understanding of various insurance products, including Medicare Advantage plans
Manage high-volume workloads efficiently while maintaining accuracy and meeting production goals
Collaborate with team members to handle complex claims and develop effective solutions
Utilize analytical skills to make informed decisions on resolving claims and account discrepancies
Ensure consistent and timely follow-up on accounts to achieve and exceed recovery targets

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Billing & Collections Representative II

Under the direction of the Manager Professional Billing & Coding, the Billing & ...

Location

United States , San Diego

Salary:

23.10 - 31.77 USD / Hour

Rady Children's Hospital-San Diego

Expiration Date

Until further notice

Requirements

H.S. Diploma,GED,or Equivalent
2 Years of Experience
Must possess some medical billing experience.
A certificate of completion from a medical billing course can be substituted for 1 year of experience

Job Responsibility

Resolution of all outstanding balances from all payors
Checking status of unpaid claims by telephone, websites and/or any other means available
Provide all necessary documentation required from payors to ensure accurate adjudication of claim for reimbursement
Process claims correctly following contractual arrangements
Accurately analyze each denial received by reviewing the patient acct, the remittance codes from Explanation of Benefits (EOB) and Remittance Advice (RA)
Review CCI or payor specific coding edits and take necessary steps to send a corrected claim or appeal
Report all problematic payor trends to leadership
Daily processing of assigned work queues
Review payor/clearing house rejections and making necessary corrections
Follow federal, state, and local regulatory collection guidelines as well as department and payor specific billing guidelines

What we offer

Medical, Dental, Vision, Life, Pet insurance
Retirement Plan
Tuition Assistance
Wellness program

Fulltime

Medical Collections Specialist

We are looking for a dedicated Medical Collections Specialist to join our team o...

Location

United States , Bethesda

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Proven experience in medical collections and billing processes
Strong knowledge of handling medical denials and appeals
Familiarity with Modernizing Medicine (ModMed) software
Excellent communication skills, both written and verbal
Ability to work effectively in an on-site healthcare setting
Attention to detail and strong organizational abilities
Understanding of medical insurance policies and procedures
Commitment to maintaining compliance with healthcare billing regulations

Job Responsibility

Contact patients to discuss outstanding account balances and resolve payment issues
Manage medical billing processes, ensuring accurate and timely submissions
Address and resolve medical denials and appeals with insurance providers
Collaborate with internal teams to ensure seamless handling of accounts receivable
Utilize Modernizing Medicine (ModMed) software to track and manage collections
Analyze accounts to identify discrepancies and implement corrective actions
Maintain detailed records of patient communications and payment activities
Ensure compliance with healthcare regulations and billing standards
Provide excellent customer service to patients and insurance representatives
Prepare reports on collection activities and account statuses for management review

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

New

Medical Biller / Collections Specialist

We are seeking a detail-oriented Medical Biller / Collections Specialist to supp...

Location

United States , Berkeley

Salary:

30.00 - 36.00 USD / Hour

Robert Half

Expiration Date

Until further notice

Requirements

3-4+ years of experience in medical billing, collections, accounts receivable, or revenue cycle management within a healthcare setting
Strong knowledge of insurance claims processing, denial management, appeals, payment posting, collections, and accounts receivable follow-up
Working knowledge of CPT, ICD-10, HCPCS codes, EOBs, Medicare, Medi-Cal, and commercial insurance plans
Proficiency with EMR/EHR and practice management systems, along with Microsoft Office Suite, particularly Excel
Excellent analytical, problem-solving, communication, and organizational skills with strong attention to detail

Job Responsibility

Submit, review, and process medical claims while ensuring compliance with payer requirements, coding guidelines, and billing regulations
Manage accounts receivable follow-up by researching unpaid claims, identifying denial trends, and pursuing timely reimbursement from insurance carriers
Resolve claim denials, rejections, underpayments, and billing discrepancies through appeals, corrections, and payer communication
Post insurance and patient payments, reconcile accounts, and maintain accurate documentation within billing and practice management systems
Communicate with patients, providers, insurance representatives, and internal departments regarding account balances, payment arrangements, and billing inquiries

What we offer

Medical
Vision
Dental
Life and disability insurance
401(k) plan

Customer Care Collections Senior Representative

The Senior Customer Care Collections Representative is responsible for performin...

Location

India , Chennai

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

Ability to work regularly scheduled shifts from Monday-Friday according to US time
High school diploma
1+ year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools
0-6 months of experience in a service-oriented role where you had to correspond in writing or over the phone with customers who spoke English
0-6 months of experience in a service-oriented role where you had to apply business rules to varying fact situations and make appropriate decisions

Job Responsibility

Performing outbound calls to insurance companies (in the US) to collect outstanding Accounts Receivables
Responding to customer requests by phone and/or in writing to ensure customer satisfaction and to assure that service standards are met
Analyzing medical insurance claims for quality assurance
Resolving moderately routine questions following pre-established guidelines
Performing routine research on customer inquiries
Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team

Fulltime

BPO Customer Care Collections Senior Representative

The Senior BPO Customer Care Collections Representative is responsible for manag...

Location

India , Chennai

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

Ability to work regularly scheduled shifts from Monday-Friday according to US time
High school diploma
1+ year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools
0-6 months of experience in a service-oriented role where you had to correspond in writing or over the phone with customers who spoke English
0-6 months of experience in a service-oriented role where you had to apply business rules to varying fact situations and make appropriate decisions

Job Responsibility

Performing outbound calls to insurance companies (in the US) to collect outstanding Accounts Receivables
Responding to customer requests by phone and/or in writing to ensure customer satisfaction and to assure that service standards are met
Analyzing medical insurance claims for quality assurance
Resolving moderately routine questions following pre-established guidelines
Performing routine research on customer inquiries
Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team

Select Country

Medical Collections Representative

Job Description

Job Responsibility

Requirements

Nice to have

What we offer

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