Medical Collections Specialist

Glen Burnie, MD

Full Time | Monday through Friday | 8:00 AM to 4:30 PM (In Office)

Pivotal Health

Pivotal Health is seeking a motivated and detail-oriented Medical Collections Specialist to join our growing healthcare team in Glen Burnie, Maryland. This role is ideal for someone who enjoys problem solving, working with insurance carriers, and helping drive the success of the revenue cycle process in a fast-paced healthcare environment.

As a Medical Collections Specialist, you will play a key role in resolving claim denials, researching account issues, communicating with insurance carriers, and ensuring claims are processed accurately and efficiently.

• Monitor and follow up on outstanding insurance claims
• Research and resolve claim denials and rejections
• Submit appeals electronically and through paper submissions
• Communicate directly with insurance companies to resolve billing issues and secure reimbursement
• Respond to patient and insurance billing inquiries professionally and efficiently
• Identify reimbursement trends and carrier issues and report findings to leadership
• Work closely with providers to clarify incomplete or missing claim information
• Utilize billing systems effectively to maximize workflow and claim processing efficiency
• Maintain accurate account documentation and collection activity records
• Meet productivity and quality standards while ensuring compliance with payer and regulatory requirements

• Minimum of 1 year of medical collections or medical billing experience
• Understanding of medical terminology, insurance payors, and reimbursement processes
• Experience appealing denied claims and resolving insurance discrepancies
• Strong critical thinking and problem-solving skills
• Excellent written and verbal communication skills
• Strong organizational and time management abilities
• Ability to work independently with minimal supervision
• Team player with a positive and professional attitude
• Proficiency with Microsoft Office and healthcare billing systems
• Ability to thrive in a fast-paced healthcare environment

• Competitive pay based on experience
• Stable Monday through Friday schedule
• Growing healthcare organization with career advancement opportunities
• Collaborative and supportive team environment
• Opportunity to make a direct impact on revenue cycle operations
• Full-time opportunity with long-term growth potential

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• The employee is regularly required to sit, use hands and fingers, handle or feel objects, and operate a computer, telephone, and other office equipment.
• The employee is occasionally required to stand, walk, reach, and bend.
• Specific vision abilities required by this position include close vision and the ability to adjust focus for computer-based work.
• The employee may occasionally lift and/or move items weighing up to 15 pounds.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• This position operates in a professional office environment.
• Routine use of standard office equipment such as computers, telephones, printers, scanners, and copiers is required.
• The noise level in the work environment is typically moderate.
• No significant exposure to hazardous chemicals, clinical procedures,…