Medical Collections Specialist

We are looking for a skilled Medical Collections Specialist to join our team in Sacramento, California. This Contract to potential permanent position offers the opportunity to work in an engaging and fast-paced environment where attention to detail and strong communication skills are essential. The role focuses on managing medical claims, resolving discrepancies, and ensuring timely reimbursements, with the possibility of long-term placement based on performance.

Responsibilities:
• Review and interpret contracts to identify allowed amounts and ensure proper claim adjudication.
• Analyze Explanation of Benefits (EOBs) to verify payment accuracy and patient liability.
• Communicate effectively with insurance companies to dispute denied or underpaid claims, ensuring resolution.
• Provide clear explanations to patients regarding their balances, claim outcomes, and financial responsibilities.
• Draft compelling appeals to challenge claim denials and secure appropriate reimbursements.
• Maintain a thorough understanding of various insurance products, including Medicare Advantage plans.
• Manage high-volume workloads efficiently while maintaining accuracy and meeting production goals.
• Collaborate with team members to handle complex claims and develop effective solutions.
• Utilize analytical skills to make informed decisions on resolving claims and account discrepancies.
• Ensure consistent and timely follow-up on accounts to achieve and exceed recovery targets.

Qualifications:

• Proven experience in medical collections and healthcare revenue cycle management.
• Strong knowledge of medical terminology and insurance processes, including copay, coinsurance, and deductibles.
• Familiarity with Medicare Advantage plans and other insurance products.
• Demonstrated ability to write persuasive appeals for denied claims.
• Excellent communication skills for interacting with patients and insurance representatives.
• Ability to thrive in a fast-paced environment while maintaining accuracy and productivity.
• Strong analytical and problem-solving skills to address claim issues effectively.
• Commitment to teamwork and achieving organizational goals.

Compensation

$23.00-$24.00 Hourly

About Us

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 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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