Medical Collections Specialist

Medical Collections Specialist (In Person Position)

• Medical Collections Specialist (In Person Position)
• Full Time | Monday through Friday | 8:00 AM to 4:30 PM (In Office)

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