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.
• 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.

Preferred Qualifications

• Experience in hospital, physician practice, or healthcare revenue cycle environments.
• Proven success resolving difficult or aged accounts receivable balances.
• Experience managing high-volume denial and appeals workloads.
• Familiarity with payer-specific appeal and collection processes.

Top Skills:

• Medical Billing & Collections
• Insurance Denials & Appeals
• Commercial, Medicare & Medicaid Claims
• Insurance Follow-Up
• Accounts Receivable Resolution
• Backend Claim Recovery
• EOB & Denial Analysis
• Revenue Cycle Management (RCM)