Medical Billing Appeals & Collections Specialist

University of Southern California; Pasadena (CA); On-site; USD 36,000 - 56,000; Full time

Job summary

USC Care Medical Group in Pasadena, CA is seeking a Collector Appeal Specialist to process inpatient and outpatient claims, manage appeals, and ensure timely filing while maintaining quality standards. The role emphasizes accurate billing, denial handling, and collaboration with the billing team to optimize cash collections.

The position operates under direct supervision with standard production and quality expectations, involving multiple billing systems, including Cerner and GE Centricity, and

Qualifications

• Req High school or equivalent
• Req Experience with medical services collections for any combination of payors (Medicare, Medi-Cal/Caid, HMO, PPO, Commercial, and Private Pay).
• Req Excellent communication skills both written and oral, detail knowledge of applicable collection laws/policies/principles/etc., governing collection efforts, problem identification and resolution, insurance, medical terminology, and reimbursement procedures

Responsibilities

• Billing Tasks: Analyzes and determines which billing procedure to follow; processes claims; edits charges; submits claims; maintains patient confidentiality; transmits claims electronically; follows up on accounts for all payors; communicates issues to supervisors; uses Cerner, AIDX/GE and other systems.
• Follow Up – Collections: follows up and collects on accounts; maintains portfolios; documents activity; negotiates settlements; responds to inquiries; reviews EOBs and denials; identifies delinquency and actions.
• Adjustments / Write-Offs / Updates: submits adjustments; transfers charges; updates payer data; maintains records; resolves credit balances; uses GECB ETM notes; attends seminars and trainings.

Job description

USC Care Medical Group in Pasadena, CA is seeking a Collector Appeal Specialist to process inpatient and outpatient claims, manage appeals, and ensure timely filing while maintaining quality standards. The role emphasizes accurate billing, denial handling, and collaboration with the billing team to optimize cash collections.

The position operates under direct supervision with standard production and quality expectations, involving multiple billing systems, including Cerner and GE Centricity, and