Collections Specialist/Revenue Cycle Specialist

Job Description

Job Description

Position Summary

Seeking an experienced PFS Collection Specialist with a strong background in hospital billing, insurance collections, patient accounting, and revenue cycle operations. The ideal candidate will have hands-on experience managing insurance follow-up, resolving denied claims, reviewing payer contracts, and working within EPIC's back-end systems.

Required Qualifications

• High School Diploma or equivalent.
• Minimum 2+ years of medical billing, collections, accounts receivable, or revenue cycle experience in a healthcare environment.
• Strong experience with insurance follow-up and payer collections.
• EPIC back-end experience is required.
• Knowledge of CPT, ICD-10, UB-04, EOBs, and insurance claims processing.
• Proficiency with Microsoft Office Suite (Excel, Outlook, Word).

Key Responsibilities

• Perform insurance follow-up and collections on outstanding hospital accounts.
• Review claim status through payer portals and telephone follow-up.
• Investigate denials, underpayments, and reimbursement discrepancies.
• Interpret payer contracts and apply contract language to reimbursement issues.
• Process claim corrections, resubmissions, appeals, and supporting documentation.
• Maintain accurate collection notes and account documentation.
• Reconcile account balances and verify payments.
• Ensure compliance with Medicare, Medi-Cal, commercial insurance, and regulatory billing requirements.
• Manage aged accounts receivable inventory and prioritize high-dollar accounts.
• Communicate payer trends, collection barriers, and escalation issues to management.
• Participate in team meetings, training sessions, and performance improvement initiatives.

Preferred Experience

• 3–5 years of hospital-based billing and collections experience.
• Experience with third-party payer collections and revenue cycle management.
• Strong analytical, communication, and problem-solving skills.
• Familiarity with managed care contracts and reimbursement methodologies.

AlphaProTemps is specialized in providing "best-in-class" professional staff augmentation services. These recruiting directives include temporary labor, contract sourcing, professional & technical niches, vendor-on-site, and managed service programs.

Company Description

AlphaProTemps is specialized in providing "best-in-class" professional staff augmentation services. These recruiting directives include temporary labor, contract sourcing, professional & technical niches, vendor-on-site, and managed service programs.