Health Claims Collections Specialist

Job Summary

A company is looking for a Health Claims Collections Specialist II.

Key Responsibilities

• Manage a portfolio of high-priority and complex claims requiring advanced solutions and strategies
• Analyze denials and execute action plans including appeals, escalations, and payer outreach
• Identify payer trends and escalate issues with supporting data to payer contacts and leadership

Required Qualifications

• High School Diploma or Equivalent Experience
• Minimum 2+ years of medical collection or revenue cycle experience with emphasis on post-billing DME or orthopedic claims
• Advanced knowledge of payer guidelines and appeals processes
• Proficiency in reading and interpreting EOBs and payer policies
• Strong working knowledge of ICD-10, HCPCs, and billing procedures for CMS-1500 claim forms