Medical Collections Specialist

Robert Half • Irvine, CA • 2d ago

Description We are looking for a skilled Medical Collections Specialist to join our team in Irvine, California. This is a Contract-to-Permanent position, offering an excellent opportunity to grow your career in a dynamic healthcare environment. The ideal candidate will play a vital role in managing accounts receivable, resolving payment discrepancies, and ensuring compliance with industry regulations.

Responsibilities:

Manage accounts receivable by following up on outstanding payments, payment errors, and claim denials.

Analyze insurance Explanation of Benefits (EOBs) and initiate appeals when necessary to resolve discrepancies.

Maintain detailed documentation of account issues, resolutions, and follow-up actions for patient records.

Prepare and send required documentation via mail or other channels to support claims processing.

Stay informed about commercial and managed care pricing models, as well as relevant rules and regulations.

Ensure compliance with organizational policies and healthcare laws, safeguarding patient confidentiality at all times.

Participate in compliance training sessions and promptly report any concerns or incidents to management.

Utilize systems such as EHR platforms, Epic Software, and IBM AS/400 to ensure efficient claims and collections processes.

Support the team by performing additional tasks as directed by supervisors or management.

Contribute to the overall success of the department by collaborating with colleagues to meet organizational goals. Requirements - Proven experience in medical collections or accounts receivable management within the healthcare industry.

Proficiency with tools such as Accurint, Dynamic Data Exchange (DDE), EHR systems, Epic Software, and IBM AS/400.

Solid understanding of billing functions, claim administration, and appeals processes.

Familiarity with commercial insurance and managed care regulations, including pricing models and compliance standards.

Strong problem-solving skills to address payment discrepancies and resolve claim denials.

Excellent communication and organizational abilities to maintain accurate documentation and coordinate with team members.

Knowledge of confidentiality requirements and experience handling sensitive patient information securely.

Ability to work independently as well as collaboratively in a fast-paced, results-driven environment.

Robert Half is the world's first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more.

All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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