Medical Collections Specialist

Medical Collections Specialist

We are seeking an experienced Medical Collections Specialist to process and follow up on physician claims from various payer types (HMO, PPO, Medi-Cal, Medicare, etc.) to ensure timely payment for services rendered.

Duties:

• Review and analyze medical documentation and patient records for accurate and timely billing entry; assign or reassign appropriate medical codes (ICD-10, CPT, HCPC) for diagnoses, procedures, and services rendered.
• Follow up with payers (HMO, PPO, Medi-Cal, Medicare, etc.) on unpaid or denied claims and resubmit as necessary.
• Process payments from insurance companies and patients.
• Maintain accurate and up-to-date patient billing records.
• Answer patient inquiries regarding billing and insurance coverage.
• Work A/R aging reports and collaborate with insurance companies to identify and correct coding/billing errors.
• Write and submit appeals to insurance companies, as needed.

Experience:

• 3-4 years of experience in medical revenue cycle management, including collections experience.
• MUST have experience using EHR system, experience with EPIC is a plus
• Proficiency in medical terminology, knowledge of ICD-10 and CPT codes, and medical collection procedures and practices.
• Familiarity with the full collections cycle, including re-bills, code corrections, aging reports, and appeals.
• Expertise with HMO, PPO, Medi-Cal, and Medicare

Note: This is not an entry-level position. Prior experience in medical billing/collections is required.

Schedule:

Monday to Friday (7:00 am - 3:30 pm OR 7:30 am - 4:00 pm)

Work Site:

Newport Beach/John Wayne Airport Area - Must be able to work onsite 100% during temp period.

Benefits after Temp to Hire Period:

• Health insurance coverage
• Retirement plan options with a match
• Generous Paid Time Off (PTO) and paid holidays
• Hybrid - 2 days in office