Medical Billing & Collections Specialist

Position Overview

We are seeking a Medical Billing & Collections Specialist to join a healthcare revenue cycle team in Columbia, MD. This role is heavily focused on insurance collections, complex claim denials, and appeals management . The ideal candidate has experience working difficult accounts, recovering outstanding reimbursements, and navigating appeals with commercial insurance, Medicare, and Medicaid payers.

Key Responsibilities

• Manage and resolve complex denied, underpaid, and outstanding insurance claims.
• Conduct follow-up with insurance carriers to secure reimbursement on unpaid accounts.
• Research claim denials and identify appropriate corrective actions.
• Prepare, submit, and track first-level and second-level appeals.
• Work extensively with commercial insurance, Medicare, and Medicaid payers.
• Analyze EOBs and remittance advice to determine denial root causes.
• Escalate and resolve high-dollar or complicated reimbursement issues.
• Maintain documentation of collection efforts, appeals activity, and claim resolutions.
• Meet productivity and quality standards while working assigned accounts.

Required Qualifications

• High School Diploma or GED.
• U.S. Citizen.
• Minimum 2+ years of medical billing and collections experience.
• Strong experience handling complex insurance denials and appeals .
• Experience with insurance follow-up, collections, and reimbursement recovery.
• Knowledge of commercial insurance, Medicare, and Medicaid guidelines.
• Ability to interpret EOBs, remittance advice, and denial codes.
• Experience working backend accounts receivable (AR) and claim resolution.
• Strong problem-solving, analytical, and communication skills.