Medical Collections Specialist (Hospital/Insurance Follow-Up)A healthcare organization is seeking experienced Medical Collections Specialists to support insurance follow-up and full-cycle claims resolution. This role focuses on working claims from start to finish, including research, denial resolution, rebilling, and appeals.Candidates must be located in San Antonio, TX. While the role is currently remote, there is a possibility of transitioning onsite in the future.Key ResponsibilitiesPerform insurance follow-up on outstanding and aged claimsWork claims from initial billing through final resolutionResearch and resolve denied or underpaid claimsReview Explanation of Benefits (EOBs) and determine next stepsSubmit appeals, rebills, and tracersIdentify and process adjustments, refunds, and bad debt accountsCommunicate with insurance companies, patients, and third-party payersVerify billing information for both electronic and paper claimsReview remittance advice and ensure accurate reimbursementResearch payer guidelines and contracts to resolve discrepanciesAnalyze claims and make decisions quickly to drive resolutionProductivity ExpectationsTarget of 18–20 claims per dayStrong emphasis on quality, accuracy, and timely follow-upRequired Qualifications2+ years of medical collections experienceExperience working with UB-04 (hospital billing)Strong understanding of insurance follow-up and denial resolutionKnowledge of reimbursement methodologiesAbility to analyze claims and problem-solve independentlyBasic Excel and computer proficiencyPreferred QualificationsInpatient (IP) or hospital collections experienceExperience in LTACH (Long-Term Acute Care Hospital) settingsSystems UsedWellSkyHMSPayer portalsWork EnvironmentRemote role (must reside in San Antonio, TX)Potential for future onsite requirementCentral Business Office (CBO) settingCollaborative, team-based environmentAdditional Details2-week training period on systems and processesNo planned time off allowed during the first 90 days (training period)Candidates should demonstrate job stability and long-term interestStrong communication skills required, including the ability to clearly explain past experienceWhat Success Looks LikeAbility to independently research and resolve complex claimsStrong critical thinking and attention to detailConsistent productivity while maintaining accuracyProactive communication and follow-throughAddison Group is an Equal Opportunity Employer.
Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.