Medical Billing/Patient Collections Specialist (IN-OFFICE -NOT REMOTE)

Job Description

Job Description

Benefits:

• Paid time off
• Employee discounts

****This is a fully in-office position located in Santa Clarita, CA. Only candidates who currently live within a reasonable daily commute will be considered****

Multi-disciplinary practice (Chiropractic, Acupuncture, Physical Therapy, and General Medicine) seeking a detail-oriented and experienced Medical Billing Specialist for Collections to join our team. The primary responsibility of this role is to manage patient balances, and outstanding insurance claims, ensuring timely payment and resolution of issues. The ideal candidate will have a strong understanding of medical billing, insurance procedures, and collection strategies, with a focus on maintaining a positive relationship with both insurance companies and patients.

KEY RESPONSIBILITIES:

• Respond to patient questions regarding statements and balances via phone, email, and in-office.
• Work with insurance adjusters, providers, and patients to resolve discrepancies or denied claims.
• Communicate findings, adjustments, and recommendations to patients, carriers, and staff.
• Work delinquent patient accounts through outreach and establish payment plans when necessary.
• Assign uncollectible accounts to a collection agency per policy.
• Review and process insurance claims for payment, ensuring accuracy of submitted claims.
• Follow up on outstanding claims with insurance companies, ensuring proper resolution and timely payment.
• Monitor aging reports and take appropriate action to resolve outstanding balances.
• Maintain accurate and organized records of collection activities, including phone calls, emails, and payment arrangements.
• Provide assistance and information to the billing team and management regarding account status and any potential collection concerns.
• Ensure compliance with all relevant regulations, including HIPAA and insurance requirements.
• Coordinate with the accounts receivable team to ensure the accurate posting of payments and adjustments.
• Resolve disputes and issues promptly while maintaining professionalism and a focus on customer service.
• Assist in monthly and quarterly reporting of collections and revenue cycle metrics.

Qualifications:

• High school diploma required; college coursework or medical billing/coding certification preferred.
• Proven experience (2+ years) in medical billing, coding, and collections within a healthcare setting preferred, but not required.
• Knowledge of insurance policies, payment structures, and medical terminology.
• Strong understanding of medical billing software and electronic health record (EHR) systems.
• Strong ability to navigate clearinghouse (Trizetto, Waystar, etc.)
• Deep understanding of claim management, including corrected claim submissions.
• Familiarity with claim modifiers (chiropractic, acupuncture, physical therapy, and general medicine).
• Experience with American Specialty Health (ASH) is a plus.
• Experience with insurance verification and claims submission processes.
• Excellent communication skills, both written and verbal, with the ability to interact effectively with patients, healthcare providers, and insurance companies.
• Strong organizational and time-management skills, with the ability to prioritize tasks and meet deadlines.
• Ability to handle sensitive and confidential information with discretion.

****This is a fully in-office position located in Santa Clarita, CA. Only candidates who currently live within a reasonable daily commute will be considered****