Medical Billing Specialist- Collector

Mens Health Foundation • Los Angeles, CA

3h • $26 - $32

About The Position

The Medical Collector / Accounts Receivable Representative is responsible for professional provider-side insurance collections, Accounts Receivable (AR) follow-up, denial resolution, reconsiderations, and appeals. The position requires advanced payer knowledge and the ability to independently research and resolve unpaid, underpaid, rejected, and denied claims through final resolution.

Requirements

• Minimum five (5) years of recent professional/provider-side medical collections and Accounts Receivable experience.
• Extensive experience with Commercial insurance, Medicare, Medi-Cal/Medicaid, Medicare Advantage, Medi-Cal Managed Care, HMO, PPO, and other third-party payers.
• Strong hands-on experience with claim reconsiderations, corrected claims, formal appeals, and complex denial resolution.
• Working knowledge of CMS-1500 claims, CPT, HCPCS, ICD-10-CM, modifiers, Place of Service, NPI/taxonomy, COB, eligibility, authorizations, and timely filing requirements.
• Ability to interpret EOBs, ERAs, payer correspondence, contractual adjustments, deductibles, copays, and coinsurance.
• Experience with payer portals, clearinghouses, Practice Management systems, Microsoft Excel, Outlook, and Teams.
• Strong attention to detail and high level of accuracy.
• Ability to meet productivity and quality standards in a fast-paced environment.
• Strong analytical and problem-solving skills.
• Excellent organizational and time management abilities.
• Ability to work independently and collaboratively.
• Effective communication skills, both written and verbal.
• High level of accountability and professionalism.
• Maintain confidentiality of patient and financial information.
• Maintain compliance with HIPAA and company policies.
• Meet or exceed departmental productivity benchmarks.
• Adheres to company attendance and performance standards.
• High School Diploma or equivalent.
• Must be able to pass a pre-employment drug test, physical, and a background check to include a 7-year criminal, 10-year SSN & employer history reference check.
• Must be able to provide proof of COVID-19 vaccination on the first day of work.
• Excellent interpersonal skills.
• Attention to detail.
• Must be able to work flexible schedules.
• Must take yearly flu shot or wear flu mask during flu season for patient-facing positions and test for tuberculosis as required by the Centers for Disease Control and Prevention.

Nice To Haves

• Experience in a physician group, specialty practice, multispecialty organization, or other high-volume professional billing environment.
• Experience managing AR over 90/120 days, high-dollar claims, payer escalations, denial analysis, and AR cleanup projects.
• Strong familiarity with California Medicare and Medi-Cal payer requirements.

Responsibilities

• Manage assigned insurance AR from initial follow-up through final resolution.
• Follow up on unpaid, underpaid, rejected, and denied professional claims using payer portals, telephone, electronic inquiry, and written correspondence.
• Prepare and submit corrected claims, claim reconsiderations, first- and second-level appeals, and supporting documentation.
• Review EOBs/ERAs, claim history, denial codes, authorization requirements, medical necessity, timely filing, and payer-specific billing requirements.
• Prioritize aged, high-dollar, and deadline-sensitive accounts and maintain follow-up until payment or appropriate final disposition.
• Document all account activity, payer contacts, reference numbers, actions taken, appeal status, and next follow-up date in the Practice Management system.
• Identify recurring payer issues and denial trends and escalate significant findings to management.
• Meet established productivity, quality, collection, and AR reduction expectations while supporting departmental priorities.

Benefits

• Medical, Dental, Vision, Life and LTD insurance (may be eligible on the 1st of the month following date of hire)
• 12 Paid Holidays (including 1 mental health day)
• 401(k) Retirement plan (may be eligible for employer matching up to 4% following completion of 90th day of employment)
• Flexible Spending Account (FSA)
• 40 hours of sick pay (following completion of 90th day of employment)
• 120 hours of PTO accrued within the 1st year of employment

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED