Medical Collections Specialist

A respected hospital in the San Fernando Valley is seeking an experienced and results-driven Hospital Medical Collections Specialist to join its revenue cycle team. This role is ideal for a motivated professional with a strong background in hospital collections, payer follow-up, and denial resolution. The ideal candidate will play a key role in accelerating reimbursements, reducing aging accounts receivable, and ensuring accurate resolution of inpatient and outpatient claims across a variety of payer sources.

The hospital is open to candidates with 2+ years of medical collections experience, particularly within an acute care or hospital setting.

Key Responsibilities

• Perform comprehensive follow-up on outstanding hospital accounts to secure accurate and timely reimbursement from insurance carriers and third-party payers
• Review inpatient and outpatient claims to identify billing issues, denials, payment delays, and underpayments, and take proactive steps toward resolution
• Manage collection efforts across multiple payer types, including Medicare Managed Care, Medi-Cal Managed Care, commercial insurance plans, HMOs, and PPOs
• Prepare and submit appeals, reconsiderations, and supporting documentation for denied or improperly processed claims
• Research and resolve account discrepancies by reviewing billing records, remittance advice, payer correspondence, and claim history
• Collaborate with billing, coding, admissions, and clinical departments to correct claim issues and improve reimbursement outcomes
• Maintain accurate and detailed documentation of collection activity, payer communications, and account status updates
• Monitor assigned accounts to reduce aging AR and improve overall collection performance
• Support departmental goals related to cash collections, denial management, and revenue cycle efficiency

Qualifications:

• Minimum of 2 years of hospital medical collections or healthcare revenue cycle experience required
• Strong understanding of hospital billing, insurance follow-up, and denial management processes
• Experience working with government and commercial payers, including Medicare and Medi-Cal managed care plans
• Knowledge of inpatient and outpatient claim processing preferred
• Excellent analytical, problem-solving, and communication skills
• Ability to work independently in a fast-paced healthcare environment while managing multiple priorities
• Proficiency in healthcare billing systems and Microsoft Office applications

Compensation

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