Collections Specialist

Qualifications:

• High school diploma or GED required
• Associate degree in Accounting, Business, or Healthcare Administration preferred
• Minimum 1–2 years of experience in medical collections, healthcare billing, or a similar role in a hospital or clinic
• Familiarity with EHR and billing systems (e.g., Epic, Cerner, Meditech) is highly desirable
• Strong knowledge of insurance claims processes, CPT/ICD-10 coding basics, and third-party payer requirements
• Excellent communication, negotiation, and problem-solving skills
• Able to manage multiple accounts and prioritize tasks in a fast-paced environment

Responsibilities

• Maintain and manage aged accounts receivable for both patient and insurance balances
• Contact patients, insurance companies, and third-party payers to collect overdue balances via phone, email, or written correspondence
• Review and resolve claim denials and underpayments, including filing appeals when necessary
• Work closely with the billing team to ensure accurate claim submissions and resolve billing discrepancies
• Educate patients on their balances, insurance coverage, and payment plan options
• Document all collection activities and patient interactions in the hospital’s electronic health record (EHR) or billing system
• Meet or exceed departmental productivity and collection goals
• Stay updated on payer guidelines, insurance policies, and federal/state regulations (HIPAA, FDCPA, etc.)
• Maintain patient confidentiality and treat all individuals with respect and professionalism
• Follow-up on accounts with outstanding balances that do not have appropriate payment arrangements

Physical Demands

• Prolonged periods sitting at a desk and working on a computer
• Occasional lifting of office supplies and files (up to 15 lbs.)