Insurance Claims & Collections Specialist - Medicare/Medicaid

Coral West Community Hospital; Miami (FL); Hybrid; USD 48,000 - 64,000; Full time

Job summary

Coral West Community Hospital is seeking a Medical Insurance Collections Specialist to resolve aged claims and optimize reimbursement. The role involves contacting insurance carriers, resubmitting claims, and preparing appeals to recover funds.

The candidate will identify denial causes, handle complex calls, and collaborate with internal teams to improve cash flow. Strong analytical and communication skills are essential for success.

Qualifications

• 2+ years in Medical Billing and Collections.
• Knowledge of ICD-10, CPT and HCPCS coding.
• Experience with Medicare/Medicaid billing guidelines.
• Experience with billing and collections of physician commercial insurances.

Responsibilities

• Contact insurance carriers for claim status updates and resubmission as needed.
• Follow up on claim denials and rejections; communicate with payers and third parties.
• Prepare and submit appeals when necessary.
• Identify denial causes and escalating issues to appropriate teams.
• Work accounts based on aging reports within the claims system and collect monies owed.
• Compile information and prepare reports on collection activities for the business office manager.

Skills

Medical Billing

Collections

ICD-10/CPT/HCPCS

Medicare/Medicaid

MS Word/Excel/Outlook

Data entry

Tools

MS Word

MS Excel

Outlook

Medical Billing Software

Job description

Coral West Community Hospital is seeking a Medical Insurance Collections Specialist to resolve aged claims and optimize reimbursement. The role involves contacting insurance carriers, resubmitting claims, and preparing appeals to recover funds.

The candidate will identify denial causes, handle complex calls, and collaborate with internal teams to improve cash flow. Strong analytical and communication skills are essential for success.