Medical Collections Specialist

Medical Collections Specialist

A hospital in Los Angeles is seeking a Medical Collections Specialist with experience in credit balances. The Medical Collections Specialist must be successful with investigating, tracking, and resolving denied medical insurance claims. The Medical Collections Specialist must have two years of medical billing and medical insurance collections experience.

Responsibilities include :

• Investigating and resolving denied claims from various insurance providers.
• Reviewing credit balances and denials management.
• Conducting thorough and detailed reviews of patient bills, insurance benefits, and medical records to identify discrepancies and ensure proper billing.
• Following up on outstanding claim denials and securing reimbursement where possible.
• Liaising with insurance companies, healthcare providers, and patients to rectify claims denials and resolve discrepancies.
• Identifying patterns and trends in claim denials and proposing solutions for reducing denial rates.
• Submitting appeals and reconsideration requests to insurance companies for denied claims.
• Strong understanding of HMO and PPO.

Requirements :