Healthcare Accounts Collection Specialist

Job Overview We are seeking a detail-oriented Healthcare Accounts Collection Specialist to manage hospital facility claims and optimize reimbursement. This role focuses on inpatient and outpatient collections, handling UB-04 institutional claims across all lines of business, and navigating complex payer guidelines.

Key Responsibilities for a Healthcare Accounts Collection Specialist

• Review accounts receivable aging reports and prioritize high-value collection activities.
• Contact insurance carriers to resolve outstanding balances, unpaid claims, and payment variances.
• Investigate, manage, and appeal denied or underpaid claims to maximize reimbursement.
• Verify patient eligibility and coverage using payer web portals and insurance customer service channels.
• Maintain institutional claim expertise with UB-04 forms, hospital billing workflows, CPT/ICD coding, and DRG reimbursement structures.
• Collaborate with internal departments, including billing teams, to resolve claim discrepancies swiftly.
• Maintain precise, detailed records of all collection actions within healthcare billing systems.
• Adhere strictly to HIPAA guidelines, regulatory compliance standards, and internal operating policies.

Qualifications & Requirements for a Healthcare Accounts Collection Specialist

• Education: High School Diploma or GED required.
• Experience: 1–3 years in hospital accounts receivable, medical follow-up, or healthcare collections.
• Required Expertise: Proven track record in inpatient and outpatient facility claims (UB-04) across Medicare, Medicaid, and commercial payers.
• Technical Skills: Proficiency in hospital billing systems, claim follow-up software, and Microsoft Office Suite.
• Core Competencies: Strong analytical ability for denial resolution, effective verbal/written communication for payer negotiation, and meticulous attention to detail.

Schedule & Attire for a Healthcare Accounts Collection Specialist

• Shift Options: Day shifts available (7:00 AM – 3:30 PM | 7:30 AM – 4:00 PM | 8:00 AM – 4:30 PM | 8:30 AM – 5:00 PM)
• Dress Code: Business Casual