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We are looking for a detail-oriented and experienced Medical Collections Specialist to join our team in Sacramento, California. In this Contract-to-permanent role, you will play a key part in managing accounts receivable, resolving claim denials, and ensuring accurate reimbursements from insurance providers. This position will be performed on-site during the contract assignment, with the potential for long-term employment based on your performance.
Job Responsibility:
Review and interpret contracts to determine allowed amounts for claims
Analyze Explanation of Benefits (EOBs) to resolve discrepancies and ensure proper adjudication
Communicate with insurance providers to address and resolve denied or underpaid claims
Educate patients about their account balances, including copays, coinsurance, deductibles, and other adjudication outcomes
Write effective appeals to challenge and overturn denied claims
Stay knowledgeable about various insurance products, including Medicare Advantage plans and other private policies
Maintain high levels of productivity and accuracy in a fast-paced work environment
Collaborate effectively within a team to achieve and surpass performance goals
Utilize strong analytical skills to determine the best course of action for claim resolution
Ensure timely and thorough follow-up on accounts to meet production targets
Requirements:
Proven experience in medical collections or healthcare revenue cycle processes
Familiarity with medical terminology and insurance claim adjudication
Strong understanding of copays, deductibles, coinsurance, and out-of-pocket maximums
Ability to read and interpret insurance contracts and Explanation of Benefits (EOBs)
Skilled in writing clear and persuasive appeals for claim denials
Comfortable working with insurance companies and patients to resolve account issues
Excellent organizational and time-management skills to handle high volumes of work
Ability to thrive under pressure and meet performance goals consistently
What we offer:
medical, vision, dental, and life and disability insurance