Medical Collections Specialist - Medicaid

Davita Inc.; San Antonio (TX); Remote; USD 10,000 - 60,000; Full time

Job summary

A leading healthcare company seeks an entry-level claims specialist to manage resolution of unpaid Medicare claims. Candidates should possess strong analytical skills, be proficient in Microsoft Office, and have a high school diploma. This fully remote position offers competitive pay and comprehensive benefits.

Benefits

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Short and long-term disability

Health Spending Account (HSA)

Transportation benefits

Employee Assistance Program

Time Off/Leave

Qualifications

• Minimum 6 months of insurance collections experience.
• Proficiency in Microsoft Office tools.
• Strong written and verbal communication skills.

Responsibilities

• Review and resolve unpaid or underpaid Medicare claims.
• Conduct root cause analysis on denials and develop resolutions.
• Maintain positive relationships with payers and clinical teams.

Skills

Healthcare

Revenue Cycle

Collections Accounts Receivable

Claims Follow Up

Claims Denials

Medicare

Medicaid

Education

High school diploma or equivalent (GED)

Tools

Microsoft Office

Job description

*Description*

production based role: fast paced with claim work, steady at submitting adjustments and understanding payor payments

This team reviews claims after they've been paid or denied by insurance payers. This team needs to review each claim to understand why they were not paid in full and resolve moving forward.

Root cause review - looking at claims to identify why they were denied, why they were short paid, and taking the steps to correct those issues and collect the outstanding revenue.

30 claims per day specific to Medicaid bad debt, which is a unique denial code. resolve through outbound calls to payers and working in payer portals

* Research, initiate follow-up, and resolve all unpaid or underpaid system debit balances on Medicare insurance claims; Actions include but are not limited to remit and EOB review, calling payer(s) and clinics, rebilling claims, navigating payer portals, and taking adjustments in the billing system
* Uses critical thinking, problem-solving and analytical skills to determine the root cause of our underpayments and follow appropriate documented policy and procedure to remediate
* Navigate through various payer systems and multiple internal systems to ensure timely and accurate resolution of Medicare claims
* Uses exceptional organization, written, and verbal communication skills to produce detailed documentation of research and actions taken on claims
* Stay current on communication relating to healthcare reimbursement and regulatory changes
* Develop and maintain positive working relationships with clinical personnel, teammates, and payer representatives
* Works well under pressure in a fast-paced environment, meets expectations of deadlines, and carries out assignments to completion while maintaining a positive attitude
* Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies
* Consistent and punctual attendance as scheduled is an essential responsibility of this position

*Skills*

healthcare, revenue cycle, collections accounts receivable, Emr, Epic, claims follow up, claims denials, claims appeals, medicare, medicaid, EOB, rebill claims

*Top Skills Details*

healthcare,revenue cycle,collections accounts receivable

*Additional Skills & Qualifications*

Required Qualifications:
- min 6 months of insurance collections experience. able to call an insurance company directly and work through provider portals to collect on outstanding claims.
- highly prefer medicare or medicaid collections experience
*High school diploma or equivalent (GED)
*Proficiency in Microsoft office tools such as Outlook, Word, PowerPoint, Excel, and OneNote
*Excellent and demonstrated written and verbal communication skills
*Computer competency; typing, basic computer troubleshooting, and navigation
*Ability to problem solve and critically think root cause analysis

DISQUALIFIERS - do not want someone who has RCM experience without collections, front end claims submission and billing is not detailed enough.

*Experience Level*

Entry Level
*Pay and Benefits*
The pay range for this position is $22.00 - $22.00/hr.
Eligibility requirements apply to some benefits and may depend on your job
classification and length of employment. Benefits are subject to change and may be
subject to specific elections, plan, or program terms. If eligible, the benefits
available for this temporary role may include the following:
* Medical, dental & vision
* Critical Illness, Accident, and Hospital
* 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
* Life Insurance (Voluntary Life & AD&D for the employee and dependents)
* Short and long-term disability
* Health Spending Account (HSA)
* Transportation benefits
* Employee Assistance Program
* Time Off/Leave (PTO, Vacation or Sick Leave)
*Workplace Type*
This is a fully remote position.
*Application Deadline*
This position is anticipated to close on Jun 13, 2025.
About TEKsystems and TEKsystems Global Services

We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.


The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.