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Join a mission-driven healthcare team where your expertise directly impacts patient care and organizational success. We are seeking an experienced Hospital Medical Collections Specialist to support revenue cycle operations in a fast-paced hospital environment. This Hospital Medical Collections Specialist opportunity is ideal for a detail-oriented professional with a strong background in hospital billing, insurance follow-up, and complex claims resolution across inpatient and outpatient accounts. In this role, you will play a critical part in maximizing reimbursement, resolving denied and underpaid claims, and partnering with internal teams to improve financial outcomes. The ideal candidate thrives in a collaborative environment, understands payer regulations, and is highly skilled in navigating hospital collections with urgency and accuracy.
Job Responsibility
Drive resolution of outstanding hospital claims by reviewing account status, contacting payers, and securing timely reimbursement
Manage collection activity across a diverse portfolio of insurance plans, including Medicare Managed Care, Medi-Cal Managed Care, commercial payers, and HMO/PPO products
Research denied and underpaid claims, identify root causes, and prepare compelling appeals with supporting documentation
Handle both inpatient and outpatient hospital billing accounts while ensuring compliance with payer requirements and contractual guidelines
Analyze payment activity, billing edits, and account trends to identify reimbursement barriers and implement corrective actions
Maintain thorough and accurate documentation of payer communication, follow-up activity, and account resolution steps
Collaborate closely with billing, coding, and revenue cycle teams to resolve claim discrepancies and improve collection performance
Adapt to department workflows and support Collector I-level processes and training initiatives as needed
Requirements
At least 3 years of experience in hospital billing and collections within a healthcare or hospital environment
Working knowledge of medical billing, medical collections, denials management, and appeals processing
Hands-on experience with hospital revenue cycle operations for both inpatient and outpatient accounts
Familiarity with Medicare managed care, Medi-Cal managed care, commercial insurance, and HMO/PPO reimbursement structures
Ability to review account details, identify payment issues, and resolve balances through organized follow-up
Strong written and verbal communication skills for payer outreach, documentation, and appeal preparation
High attention to detail and the ability to manage multiple accounts while meeting productivity expectations
What we offer
medical, vision, dental, and life and disability insurance