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Description

A Hospital is looking for an experienced Medical Collections Specialist to join its Medical Revenue Cycle team. In this role, you will focus on managing insurance collections and claims for acute care facilities, ensuring accurate and timely processing of UB-04 forms.

Responsibilities:

• Oversee the collection process for medical insurance claims, including HMO and PPO plans.

• Accurately process UB-04 claims for both inpatient and outpatient hospital services.

• Investigate and resolve unpaid claims by following up with insurance providers.

• Address payment denials and discrepancies through appeals and effective communication.

• Collaborate with internal teams and external payers to ensure timely resolution of outstanding accounts.

• Maintain compliance with insurance policies, hospital regulations, and industry standards.

• Document claim statuses and updates in the designated systems with precision.

• Support hospital revenue cycle activities by ensuring accurate billing and collections.

Requirements • Minimum of 3 years of experience in medical billing and collections.

• Proficient in handling UB-04 forms and hospital billing processes.

• Strong knowledge of medical appeals and denial management.

• Familiarity with HMO and PPO insurance plans.

• Experience in working with hospital inpatient and outpatient claims.

• Solid understanding of hospital revenue cycle operations.

• Excellent communication and problem-solving skills.

• Ability to maintain detailed and accurate records.

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