Senior Medical Collections Specialist

Located in Miami, FL

Salary: $22.00

Express Employment Professionals is seeking an experienced Senior Medical Collections Specialist to join our healthcare team in the Miami 33144 area. The ideal candidate will have 4+ years of medical collections/ Claims and a strong understanding of both insurance and patient account collections.

 

This position is responsible for managing outstanding medical accounts, following up on unpaid claims and patient balances, resolving billing issues, and helping maximize timely reimbursement while maintaining professional relationships with patients and insurance companies.

Key Responsibilities

• Experience in physician billing & collections of medical claims.

• Understanding of an Explanation of Benefits (claim denials and reason codes).

• Knowledge of CMS 1500 claim processing guidelines to effectively resolve denials through submission of Corrected Claims, Reconsiderations and/or Appeals with the goal of successfully collecting payment of our providers services.

• Ability to multitask and work independently as a team player in a fast-paced environment, demonstrating professionalism.

• Candidate should have good verbal, reading and writing skills as well as be self-motivated, meticulous, and organized with experience in Microsoft Word and Excel.

• Effectively communicate with insurance companies, document accounts, and create tasks for future follow-up.

• Contact insurance companies regarding unpaid, denied, or underpaid claims.
• Investigate and resolve claim denials, billing discrepancies, and payment issues.
• Perform patient collections while providing professional and courteous customer service.
• Submit and follow up on insurance appeals and corrected claims when necessary.
• Maintain accurate and detailed collection notes and account documentation.
• Communicate effectively with insurance carriers, patients, providers, and internal billing staff.
• Maintain confidentiality and comply with HIPAA and applicable healthcare regulations.
• Assist with identifying recurring billing or reimbursement issues and recommend solutions.

Qualifications

• 3+ years of experience in medical collections.
• Strong experience with both insurance and patient collections.
• Knowledge of medical billing, insurance claims, EOBs, denials, appeals, and reimbursement processes.
• Strong understanding of healthcare payer terminology and collection procedures.
• Excellent communication and customer service skills.
• Strong attention to detail and organizational skills.
• Ability to manage multiple accounts and prioritize workload effectively.
• Proficiency with computers and medical billing/collection software.
• Ability to work independently and as part of a team.
• Professional, dependable, and results-oriented.

Preferred Qualifications

• Experience working with physician practices, medical groups, hospitals, or healthcare organizations.
• Experience with high-volume medical accounts receivable.
• Familiarity with Medicare, Medicaid, commercial insurance, and managed-care plans.
• Experience handling aging A/R and complex account resolution.

Schedule

Full-Time

Monday–Friday during 8-5

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