Medical Collections Specialist

Baltimore, MD Full Time | Monday through Friday | 8:00 AM to 4:30 PM (In Office) Pivotal Health Pivotal Health is seeking a motivated and detail-oriented Medical Collections Specialist to join our growing healthcare team in Glen Burnie, Maryland. This role is ideal for someone who enjoys problem solving, working with insurance carriers, and helping drive the success of the revenue cycle process in a fast-paced healthcare environment. As a Medical Collections Specialist, you will play a key role in resolving claim denials, researching account issues, communicating with insurance carriers, and ensuring claims are processed accurately and efficiently. Medical Collections Specialist (In Person Position) Baltimore, MD Full Time | Monday through Friday | 8:00 AM to 4:30 PM (In Office) Pivotal Health Pivotal Health is seeking a motivated and detail-oriented Medical Collections Specialist to join our growing healthcare team in Glen Burnie, Maryland. This role is ideal for someone who enjoys problem solving, working with insurance carriers, and helping drive the success of the revenue cycle process in a fast-paced healthcare environment. As a Medical Collections Specialist, you will play a key role in resolving claim denials, researching account issues, communicating with insurance carriers, and ensuring claims are processed accurately and efficiently. What You Will Do Monitor and follow up on outstanding insurance claims Research and resolve claim denials and rejections Submit appeals electronically and through paper submissions Communicate directly with insurance companies to resolve billing issues and secure reimbursement Respond to patient and insurance billing inquiries professionally and efficiently Identify reimbursement trends and carrier issues and report findings to leadership Work closely with providers to clarify incomplete or missing claim information Utilize billing systems effectively to maximize workflow and claim processing efficiency Maintain accurate account documentation and collection activity records Meet productivity and quality standards while ensuring compliance with payer and regulatory requirements What We Are Looking For Minimum of 1 year of medical collections or medical billing experience Understanding of medical terminology, insurance payors, and reimbursement processes Experience appealing denied claims and resolving insurance discrepancies Strong critical thinking and problem-solving skills Excellent written and verbal communication skills Strong organizational and time management abilities Ability to work independently with minimal supervision Team player with a positive and professional attitude Proficiency with Microsoft Office and healthcare billing systems Ability to thrive in a fast-paced healthcare environment Why Pivotal Health? Competitive pay based on experience Stable Monday through Friday schedule Growing healthcare organization with career advancement opportunities Collaborative and supportive team environment Opportunity to make a direct impact on revenue cycle operations Full-time opportunity with long-term growth potential Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The employee is regularly required to sit, use hands and fingers, handle or feel objects, and operate a computer, telephone, and other office equipment. The employee is occasionally required to stand, walk, reach, and bend. Specific vision abilities required by this position include close vision and the ability to adjust focus for computer-based work. The employee may occasionally lift and/or move items weighing up to 15 pounds. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position operates in a professional office environment. Routine use of standard office equipment such as computers, telephones, printers, scanners, and copiers is required. The noise level in the work environment is typically moderate. No significant exposure to hazardous chemicals, clinical procedures, or laboratory environments is expected. OSHA Classification System for Evaluation of Potential Exposure to Bloodborne Pathogens This position is classified as having no occupational exposure to blood, body fluids, or other potentially infectious materials. Statement of Policy Pivotal Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, genetic information, or any other protected characteristic under applicable federal, state, or local law. Affirmative Action Plan (AAP) The Affluent Action Plans for Minorities and Women, Individuals with Disabilities, and Protected Veterans are available for inspection, by appointment, with Human Resources during regular business hours upon request. Reasonable Accommodation If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process or perform the essential functions of the job, please contact Chad Henderson at chad. View email address on click.appcast.io or dial TTY: 711 (Relay) . Employment Eligibility This employer participates in E-Verify . Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States. Equal Employment Opportunity / Affinity Action Employer Pivotal Health and its subsidiaries are committed to providing equal employment opportunities to all employees and applicants for employment. Employment decisions are based on qualifications, merit, and business needs without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, genetic information, or any other status protected by applicable law. #J-18808-Ljbffr Pivotal Health