Remote Medical Collections Specialist: Denials & Appeals

Surgery Partners, Inc; Addison (TX); Hybrid; USD 42,000 - 65,000; Full time

Job summary

Surgery Partners, Inc. is seeking a Medical Collection Specialist to ensure effective recovery of patient accounts. This hybrid/remote role requires reliable internet access and a proactive approach to work.

The ideal candidate has 3–5 years in medical billing and collections, knowledge of CPT/ICD-10 coding, insurance terms, and a strong hospital billing background. EPIC experience and spine/orthopedic billing familiarity are a plus.

Qualifications

• 3–5 years in office billing and collections (CBO)
• Knowledge of insurance, billing terms, CPT/ICD10, coding and DRG
• Knowledge of modifiers usage and CCI edits
• Strong medical insurance background
• Working knowledge of MS Office applications (Outlook, Word, Excel, PowerPoint)
• Hospital Billing/Collections experience preferred

Responsibilities

• Perform extensive insurance claim follow-ups for denials and appeals
• Interact with payer representatives, HIM, Insurance Verification and Access Service departments
• Present denial trends to management
• Read, understand, interpret and resolve payer denials and EOBs
• File corrected claims and appeals with supporting documents to insurance companies
• Work receivables to investigate and resolve denials and partial payments
• Calculate reimbursement per payer contract
• Ensure denial reviews and claim follow-ups are conducted in a timely manner

Skills

Attention to detail

Prioritize work

Medical insurance background

CPT/ICD-10 knowledge

CCI edits

EPIC experience

Orthopedic billing knowledge

Denials management

Education

High School Diploma

Tools

Outlook

Word

Excel

PowerPoint

EPIC

Job description

Surgery Partners, Inc. is seeking a Medical Collection Specialist to ensure effective recovery of patient accounts. This hybrid/remote role requires reliable internet access and a proactive approach to work.

The ideal candidate has 3–5 years in medical billing and collections, knowledge of CPT/ICD-10 coding, insurance terms, and a strong hospital billing background. EPIC experience and spine/orthopedic billing familiarity are a plus.