Medical Biller/Collections Specialist

Job Description

Job Description

A Hospital in Los Angeles is in the immediate need of a Medical Insurance Collections Specialist to support its hospital-based revenue cycle team. The Medical Insurance Collections Specialist role is ideal for someone who understands insurance follow-up, hospital claims, denials management, appeals and reimbursement workflows in a fast-paced healthcare setting. The Medical Insurance Collections Specialist will help drive payment resolution by researching claim issues, addressing payer delays, resolve denials and working closely with internal teams to improve collection results.

Responsibilities:

• Manage follow-up activities for unpaid or underpaid hospital insurance claims, with attention to high-volume payer accounts and timely reimbursement.

• Review UB04 hospital claims for accuracy, completeness, and billing compliance before pursuing collection resolution.

• Research denials, rejections, delayed payments, and partial reimbursements to determine the next steps needed for account resolution.

• Prepare and submit corrected claims, appeal packages, and supporting documents to resolve outstanding balances efficiently.

• Work aging accounts receivable inventories and maintain daily productivity aligned with departmental expectations.

• Record all account actions, payer conversations, and status updates clearly within the billing system.

• Partner with billing, coding, and patient financial services teams to resolve claim discrepancies and reduce reimbursement barriers.

• Track recurring payer issues and escalate patterns that negatively affect collection performance or payment turnaround times.

• At least 3 years of experience in medical insurance collections, healthcare accounts receivable, or insurance follow-up.
• Prior hospital billing or hospital collections experience is required.
• Hands-on experience working with UB04 claims in a hospital environment.
• Strong understanding of payer guidelines, reimbursement practices, and insurance collection processes.
• Experience handling denials, appeals, corrected claims, and payment research.
• Ability to manage a high-volume workload with strong organization and close attention to detail.
• Effective communication and problem-solving skills for interacting with payers and internal stakeholders.
• Familiarity with hospital billing platforms and electronic medical record systems is preferred.