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Description

Our team is seeking a Medical Insurance Collections Specialist with prior hospital experience to join a dynamic healthcare organization. In this role, you will play a critical part in maximizing hospital revenue by managing insurance denials, processing appeals, and handling collections related to HMO/PPO insurance claims. A strong understanding of UB-04 billing practices is required.

Key Responsibilities:

+ Review and analyze insurance denials and identify appropriate action steps for appeal or resubmission.

+ Prepare and submit timely, thorough appeals using clinical and financial data.

+ Navigate and resolve issues related to HMO/PPO insurance programs.

+ Complete and accurately review UB-04 forms for billing and appeals processes.

+ Communicate with insurance carriers to gather status updates and clarify payment issues.

+ Collaborate with hospital billing and patient accounts teams to resolve outstanding balances.

+ Document all actions and maintain compliance with HIPAA and hospital policies.

Requirements

+ Previous experience in hospital medical insurance collections is required.

+ Strong familiarity with insurance denial management and appeals.

+ Proficient in completing and reviewing UB-04 forms.

+ Experience with HMO/PPO insurance billing procedures.

+ Excellent organizational, communication, and problem-solving skills.

+ Ability to work in a fast-paced and team-oriented environment.

Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more.

All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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