Senior Healthcare Collections Specialist — Appeals & Denials

USA Clinics Group; Northbrook (IL); Sur place; USD 32 000 - 40 000; Plein temps

Avantages offerts par ce poste

Medical

Dental

Vision

PTO

Sick Time

401k

Résumé du poste

USA Clinics Group in Northbrook, IL seeks a Senior Insurance Collections Representative to resolve complex, high-dollar claims, denials, and appeals while identifying trends and mentoring junior collectors. This onsite, full-time role requires strong ownership and data-driven decision making.

Effective communication across departments and a commitment to privacy and compliance are essential. The position offers a competitive hourly pay range and opportunities to drive performance improvements

Qualifications

• High school diploma or GED.
• 4+ years of healthcare insurance collections or denial-management experience.
• Advanced experience with appeals, payer escalation, medical-necessity denials, high-dollar A/R, and root-cause analysis.
• Strong ownership, follow-through, documentation, prioritization, and escalation judgment.
• Ability to work accurately in a high-volume, deadline-driven healthcare environment.
• Ability to identify discrepancies, communicate clearly, and collaborate across departments.
• Commitment to privacy, compliance, quality, continuous improvement, and respectful service.

Responsabilités

• Own complex, aged, high-dollar, or escalated accounts through final resolution.
• Prepare evidence-based appeals and payer escalations and protect filing deadlines.
• Analyze common denial and underpayment patterns and recommend source corrections.
• Assist with bulk projects, account sampling, documentation quality, and queue strategy.
• Support junior collectors through case review, coaching, and job aids.
• Use approved technology and analytics to improve prioritization and recovery.

Connaissances

Ownership

Follow-through

Documentation

Prioritization

Escalation judgment

Formation

Associate’s degree

CPC, CPB, CRCR, or comparable certification

Description du poste

USA Clinics Group in Northbrook, IL seeks a Senior Insurance Collections Representative to resolve complex, high-dollar claims, denials, and appeals while identifying trends and mentoring junior collectors. This onsite, full-time role requires strong ownership and data-driven decision making.

Effective communication across departments and a commitment to privacy and compliance are essential. The position offers a competitive hourly pay range and opportunities to drive performance improvements