Medical Collections Specialist - Hospital Claims

Job Title: Medical Collections Specialist - Hospital Claims

Location: Tennessee (Remote)

Industry: Healthcare RCM

Pay: $22.00-$25.00 / Per Hour (Based on years of experience)

Benefits: This position is eligible for medical, dental, vision, life insurance and 401k.

About Our Client:

Addison Group is partnering with a healthcare revenue cycle organization that specializes in hospital accounts receivable recovery, denial management, and complex claims resolution. This is an excellent opportunity for experienced hospital collectors looking to join a growing remote team with strong leadership support and long-term career growth potential.

Job Description:

The Medical Collections Specialist is responsible for managing professional billing accounts receivable, researching denials, submitting appeals, and ensuring timely reimbursement from insurance carriers. This position requires strong analytical skills, knowledge of payer guidelines, and the ability to work independently while meeting productivity and quality expectations.

Key Responsibilities:

• Investigate and resolve denied, underpaid, and unpaid professional claims.
• Conduct insurance follow-up with commercial and government payers.
• Prepare and submit appeals with supporting documentation.
• Analyze denial trends and identify opportunities for process improvement.
• Review and interpret EOBs and payer correspondence.
• Ensure timely filing requirements are met for maximum reimbursement.
• Maintain detailed documentation of claim activity, appeals, and account resolutions.
• Work closely with payers to resolve reimbursement issues and claim discrepancies.
• Escalate complex accounts when additional review or intervention is needed.
• Meet established productivity and quality metrics.

Requirements:

• 2+ years of recent Hospital collections (UB04) experience required.
• Recent Epic experience required (within the last 3 years).
• Recent experience with denials, appeals, insurance follow-up, and claim resolution required.
• Ability to read and interpret EOBs and payer correspondence.
• Knowledge of commercial insurance, Medicare, Medicaid, Workers' Compensation, and managed care guidelines required.
• Strong analytical, organizational, and problem-solving skills.
• Ability to work independently in a remote environment.

Additional Details:

• Schedule: Flexible schedule between 9:00 AM – 5:30 PM

  Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.

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