Medical Billing & Collections Specialist

Insight Global; Columbia (MD); On-site; USD 40,000 - 65,000; Full time

Job summary

Insight Global is seeking a Medical Billing & Collections Specialist to join a healthcare revenue cycle team in Columbia, MD. This role is heavily focused on insurance collections, complex claim denials, and appeals management.

Ideal candidate has 2+ years in medical billing and collections, experience with commercial insurance, Medicare, and Medicaid payers, and a proven track record of recovering reimbursements.

Qualifications

• Must have 2+ years of medical billing and collections experience.
• Experience with complex insurance denials and appeals.
• Knowledge of commercial insurance, Medicare, and Medicaid guidelines.

Responsibilities

• Manage and resolve complex denied, underpaid, and outstanding insurance claims.
• Conduct follow-up with insurance carriers to secure reimbursement on unpaid accounts.
• Research claim denials and identify appropriate corrective actions.
• Prepare, submit, and track first-level and second-level appeals.
• Work extensively with commercial insurance, Medicare, and Medicaid payers.
• Analyze EOBs and remittance advice to determine denial root causes.
• Escalate and resolve high-dollar or complicated reimbursement issues.
• Maintain documentation of collection efforts, appeals activity, and claim resolutions.
• Meet productivity and quality standards while working assigned accounts.

Skills

Analytical skills

Communication

Problem solving

Attention to detail

Education

High School Diploma or GED

Job description

We are seeking a Medical Billing & Collections Specialist to join a healthcare revenue cycle team in Columbia, MD. This role is heavily focused on insurance collections, complex claim denials, and appeals management. The ideal candidate has experience working difficult accounts, recovering outstanding reimbursements, and navigating appeals with commercial insurance, Medicare, and Medicaid payers.

Key Responsibilities

• Manage and resolve complex denied, underpaid, and outstanding insurance claims.
• Conduct follow-up with insurance carriers to secure reimbursement on unpaid accounts.
• Research claim denials and identify appropriate corrective actions.
• Prepare, submit, and track first-level and second-level appeals.
• Work extensively with commercial insurance, Medicare, and Medicaid payers.
• Analyze EOBs and remittance advice to determine denial root causes.
• Escalate and resolve high-dollar or complicated reimbursement issues.
• Maintain documentation of collection efforts, appeals activity, and claim resolutions.
• Meet productivity and quality standards while working assigned accounts.

Required Qualifications

• High School Diploma or GED.
• Minimum 2+ years of medical billing and collections experience.
• Strong experience handling complex insurance denials and appeals.
• Experience with insurance follow-up, collections, and reimbursement recovery.
• Knowledge of commercial insurance, Medicare, and Medicaid guidelines.
• Ability to interpret EOBs, remittance advice, and denial codes.
• Experience working backend accounts receivable (AR) and claim resolution.
• Strong problem-solving, analytical, and communication skills.