Medical Collector

Addison Group; Addison (TX); Sur place; USD 32 000 - 40 000; Plein temps

Avantages offerts par ce poste

Modern, tech-focused office

Coffee stations

Massage chairs

Catered lunches twice per week

Comfortable break rooms

Résumé du poste

The Addison Group is hiring an experienced Arbitration Specialist for a growing healthcare organization specializing in medical billing and revenue cycle management. This role is ideal for a detail-oriented professional who investigates complex claims, researches reimbursement discrepancies, and develops strategies to maximize collections.

The position focuses on evaluating claims, identifying underlying payment issues, and preparing well-supported appeals and reconsiderations.

Qualifications

• At least 2 years of experience in medical billing, healthcare accounts receivable, claims follow-up, denial management, appeals, or revenue cycle operations.
• Ability to interpret EOBs, ERAs, denial codes, payer communications, and payment discrepancies.
• Excellent organization, attention to detail, written communication, and follow-through.
• Familiarity with medical billing software, insurance portals, Microsoft Excel, and Outlook.
• Knowledge of HIPAA guidelines and healthcare billing compliance standards.

Responsabilités

• Oversee complex accounts receivable accounts involving denials, underpayments, aging balances, and unresolved payer disputes.
• Review EOBs, ERAs, payer communications, claim histories, and guidelines to identify discrepancies.
• Draft, submit, and monitor appeals, reconsiderations, corrected claims, and supporting documentation while meeting payer deadlines.
• Research claim issues involving prior authorization, insurance eligibility, medical necessity, coding, modifiers, filing limits, and payment discrepancies.
• Partner with internal teams to resolve challenging account issues.
• Evaluate denial patterns and payer trends to improve reimbursement and share recommendations with leadership.
• Maintain complete records of claim research, appeal documentation, payer interactions, submission timelines, and outcomes.

Connaissances

Medical billing

Denial management

Appeals

Revenue cycle

Accounts receivable

Claims follow-up

Outils

Microsoft Excel

Outlook

Availity

Clearinghouse platforms

Description du poste

Compensation: $23–$29 per hour, depending on experience

About Our Client

Addison Group is hiring an experienced Arbitration Specialist on behalf of our client, a growing healthcare organization specializing in medical billing and revenue cycle management. This opportunity is ideal for a detail-oriented professional who enjoys investigating complex claims, researching reimbursement discrepancies, and developing effective strategies to maximize collections.

The organization offers a modern, technology-focused office environment with a collaborative team, comfortable break rooms, coffee stations, massage chairs, and catered lunches twice per week.

Job Description

The Arbitration Specialist will manage complex accounts receivable cases, focusing on claim denials, underpayments, appeals, and outstanding balances. This individual will use analytical skills, payer policy research, and strong written communication to determine appropriate resolutions and pursue additional reimbursement when warranted.

The ideal candidate can independently evaluate claims, identify the underlying cause of payment issues, and prepare well-supported appeals and reconsiderations.

Key Responsibilities

• Oversee complex accounts receivable accounts involving denials, underpayments, aging balances, and unresolved payer disputes.
• Review explanation of benefits (EOBs), electronic remittance advice (ERAs), payer communications, claim histories, and reimbursement guidelines to identify discrepancies.
• Draft, submit, and monitor appeals, reconsiderations, corrected claims, and supporting documentation while meeting payer deadlines.
• Research claim issues involving prior authorization, insurance eligibility, medical necessity, coding, modifiers, filing limits, and payment discrepancies.
• Partner with internal billing, coding, clinical documentation, contracting, and credentialing teams to resolve challenging account issues.
• Evaluate recurring denial patterns and payer trends, identify opportunities to improve reimbursement, and share recommendations with team leadership.
• Assist colleagues with complex account questions, escalation reviews, and appropriate claim follow-up procedures.
• Maintain complete and accurate records of claim research, appeal documentation, payer interactions, submission timelines, and resolution outcomes.
• Meet established performance and quality goals while ensuring accuracy, compliance, and effective reimbursement recovery.

Qualifications

• At least 2 years of experience in medical billing, healthcare accounts receivable, claims follow-up, denial management, appeals, or revenue cycle operations.
• Ability to interpret EOBs, ERAs, denial codes, payer communications, and payment discrepancies.
• Strong problem-solving skills and the ability to determine the best course of action for resolving outstanding claims.
• Experience researching payer requirements and preparing written appeals or reconsideration requests.
• Excellent organization, attention to detail, written communication, and follow-through.
• Familiarity with medical billing software, insurance portals, Microsoft Excel, and Outlook.
• Knowledge of HIPAA guidelines and healthcare billing compliance standards.

Preferred Qualifications:

• Background in anesthesia, physician billing, professional-fee billing, or surgical services.
• Experience with complex appeals, denial work queues, payer policy research, and reimbursement recovery.
• Familiarity with Medicare, Medicaid, commercial insurance plans, Availity, and clearinghouse platforms.
• Intermediate Excel skills, including tracking outstanding accounts, reviewing aging reports, or analyzing denial trends.
• Medical billing, coding, or revenue cycle certifications, or relevant coursework, are a plus.
• Modern, fully equipped corporate office.
• Collaborative, team-oriented work environment.
• Flexible full-time scheduling, with many team members finishing around 4:00 PM.
• Multiple coffee stations and stocked break rooms.
• Massage chairs and recreational office amenities.
• Catered team lunches on Tuesdays and Thursdays.
• Opportunity to contribute directly to revenue recovery and reimbursement improvement.

Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.