Medical Collections Specialist

NANA Healthcare Management, LLC•Doraville, GA

6d•$17 - $19•Onsite

About The Position

Medical Collections Specialist Mount Yonah Medical Billing (MYMB) is a rapidly growing third-party medical billing company specializing in behavioral healthcare revenue cycle management, with expertise in substance use disorder and mental health billing. Our mission is to help healthcare providers maximize reimbursement while maintaining the highest standards of compliance and customer service. As our company continues to expand, we are seeking a motivated and detail-oriented Medical Collections Specialist to join our collaborative team. This is an excellent opportunity for someone looking to build a long-term career in medical billing with opportunities for advancement into leadership. The Medical Collections Specialist is responsible for managing assigned accounts receivable by following up with insurance companies to ensure timely payment of medical claims. This role plays a critical part in reducing aging accounts receivable, resolving claim issues, and maximizing reimbursement through effective insurance follow-up and denial resolution. The ideal candidate is organized, analytical, and thrives in a fast-paced healthcare billing environment.

Requirements

High school diploma or GED required
Minimum of one (1) year of recent experience in medical collections, insurance follow-up, medical billing, or healthcare accounts receivable required
Knowledge of Medicare, Medicaid, and commercial insurance guidelines
Working knowledge of CPT, ICD-10-CM, HCPCS, and medical terminology
Experience using electronic medical records (EMR) and medical billing software
Strong proficiency with Microsoft Office, including Excel and Outlook
Ability to work full-time in our Doraville office

Nice To Haves

Associate degree preferred
Experience with behavioral health, mental health, or substance abuse billing preferred
Experience with CollaborateMD
Experience with Kipu EMR
Experience with Availity

Responsibilities

Review and manage assigned accounts receivable to identify unpaid, denied, or underpaid insurance claims
Contact commercial insurance carriers, Medicare, Medicaid, and other third-party payers regarding claim status
Investigate claim denials and determine the appropriate corrective action
Submit corrected claims, appeals, reconsiderations, and supporting documentation when necessary
Follow up on outstanding claims according to payer guidelines and company standards
Verify payments, contractual adjustments, write-offs, and reimbursement accuracy
Maintain detailed and accurate account documentation within the billing system
Work aging reports to meet collection and productivity goals
Collaborate with Billing, Appeals, Payment Posting, and other internal departments to resolve claim issues
Identify denial trends and communicate recurring issues to leadership
Maintain HIPAA compliance and adhere to all federal, state, and payer regulations
Participate in departmental meetings, training, and continuous process improvement initiatives