Medical Collections Specialist

About the role

The Medical Collections Specialist at Mount Yonah Medical Billing (MYMB) is responsible for managing accounts receivable, investigating claim denials, and ensuring timely payment of medical claims. This role plays a crucial part in reducing aging accounts receivable, resolving claim issues, and maximizing reimbursement.

Responsibilities

• Review and manage assigned accounts receivable to identify unpaid, denied, or underpaid insurance claims
• Contact commercial insurance carriers, Medicare, Medicaid, and other third-party payers regarding claim status
• Investigate claim denials and determine the appropriate corrective action
• Submit corrected claims, appeals, reconsiderations, and supporting documentation when necessary
• Follow up on outstanding claims according to payer guidelines and company standards
• Verify payments, contractual adjustments, write-offs, and reimbursement accuracy
• Maintain detailed and accurate account documentation within the billing system
• Work aging reports to meet collection and productivity goals
• Collaborate with Billing, Appeals, Payment Posting, and other internal departments to resolve claim issues
• Identify denial trends and communicate recurring issues to leadership
• Maintain HIPAA compliance and adhere to all federal, state, and payer regulations
• Contribute to continuous improvement of billing and collection processes

Requirements

• High school diploma or GED required
• Minimum of one (1) year of recent experience in medical collections, insurance follow-up, medical billing, or healthcare accounts receivable required
• Associate degree preferred
• Experience with behavioral health, mental health, or substance abuse billing preferred
• Knowledge of Medicare, Medicaid, and commercial insurance guidelines
• Working knowledge of CPT, ICD-10-CM, HCPCS, and medical terminology
• Strong proficiency with Microsoft Office, including Excel and Outlook

Skills & Competencies

• Insurance claims follow-up
• Medical collections and accounts receivable management
• Denial management and appeals
• Strong analytical and problem-solving abilities
• Excellent written and verbal communication skills
• Exceptional attention to detail
• Strong organizational and time-management skills
• Ability to prioritize multiple deadlines
• Ability to work independently and collaboratively within a team
• Customer service and professional communication skills

Performance Expectations

• Meet established daily, weekly, and monthly productivity goals
• Reduce aging accounts receivable within assigned inventory
• Ensure compliance with HIPAA and payer regulations
• Contribute to continuous improvement of billing and collection processes

Benefits

• Competitive hourly pay based on experience
• Paid training
• Performance bonus opportunities after 90 days
• Health insurance after 90 days
• Dental, vision, and life insurance after 90 days
• Paid Time Off (PTO)
• 401(k)
• Opportunities for advancement into leadership
• Stable Monday–Friday schedule with evenings and weekends off
• Supportive, team-oriented work environment