Remote Medical Collections & Denials Specialist

Surgery Partners Brand; Addison (TX); Hybrid; USD 50,000 - 70,000; Full time

Job summary

Surgery Partners Brand is seeking a Medical Collection Specialist to ensure effective collection of patient accounts in a hybrid/remote environment. The role emphasizes denials follow-up, appeals, and collaborating with payer representatives across payer websites and systems.

The ideal candidate has 3–5 years in medical billing/collections, knowledge of CPT/ICD10 coding, DRG, and EPIC experience is a plus. A high school diploma is required and strong MS Office skills are expected.

Qualifications

• 3–5 years experience in office billing and collections (CBO)
• High attention to detail and accuracy
• Ability to prioritize, multitask independently
• Knowledge of insurance, billing terms, CPT/ICD10, coding and DRG
• Working knowledge of MS Office (Outlook, Word, Excel, PowerPoint)
• Ability to interact with payer representatives and departments
• Spine/Orthopedic surgery experience preferred
• EPIC experience preferred
• Minimum of three years’ experience in medical collections
• Hospital Billing/Collections preferred

Responsibilities

• Perform extensive insurance claim follow-ups for denials, appeals and next steps
• Interact with payer websites and claims clearinghouse systems
• Work with payer representatives, HIM, Insurance Verification and Access Service
• Present denial trends to management
• Read and resolve payer denials and EOBs
• Understand copays, coinsurance, deductibles, and denial codes
• Ensure timely filing limits are met
• File appeals with supporting documents
• Investigate receivables and resolve denials/partial payments
• Calculate reimbursement per payer contract
• Maintain a positive attitude toward duties

Skills

Billing & collections

Insurance knowledge

CPT/ICD10 coding

CCI edits

MS Office

Critical thinking

Spine/Orthopedic experience

EPIC experience

Medical collections experience

Education

High School Diploma

Job description

Surgery Partners Brand is seeking a Medical Collection Specialist to ensure effective collection of patient accounts in a hybrid/remote environment. The role emphasizes denials follow-up, appeals, and collaborating with payer representatives across payer websites and systems.

The ideal candidate has 3–5 years in medical billing/collections, knowledge of CPT/ICD10 coding, DRG, and EPIC experience is a plus. A high school diploma is required and strong MS Office skills are expected.