Description

Are you an expert in medical collections with an in-depth understanding of insurance follow-up and contracts? A nationally ranked hospital is seeking a highly skilled Lead Hospital Medical Collections Specialist to join our revenue cycle team. This is a leadership role that requires a proactive professional with exceptional analytical and communication skills to manage the collections process, mentor a team, and ensure timely recovery of outstanding accounts.

Key Responsibilities

• Insurance Follow-Up: Oversee and execute follow-up with insurance companies to resolve and collect outstanding claims in a timely and compliant manner.

• Account Reconciliation: Investigate and analyze account discrepancies, denials, and underpayments to ensure claims are processed and payments are maximized.

• Insurance Contracts: Review and interpret insurance contracts to identify reimbursement discrepancies and ensure compliance with payer agreements.

• Claims Management: Oversee claim appeals and provide support to teammates in resolving complex denials and escalations.

• Team Leadership: Train, mentor, and guide junior medical collections specialists to maximize team performance and support department goals.

• Reporting: Generate and analyze detailed collections reports to track progress, identify trends, and recommend process improvements.

• Compliance: Ensure adherence to hospital policies, payer guidelines, and state/federal healthcare regulations.

• Collaboration: Act as a liaison between the billing department, coders, and other teams to streamline communication and enhance collections efficiency.

  Requirements

• Experience: Minimum 5+ years of experience in medical collections within a hospital or healthcare setting. Leadership or senior specialist experience preferred.

• Insurance Knowledge: Strong knowledge of insurance contracts, claim review processes, and follow-up procedures.

• Technical Skills: Proficiency in working with electronic medical record (EMR) systems (e.g., Epic, Cerner, Meditech) and billing software.

• Education: High school diploma or equivalent required; associate or bachelor's degree in healthcare, finance, or related field is preferred.

• Detail-Oriented: Exceptional attention to detail and organizational skills, particularly in reviewing contracts and reconciliations.

• Communication Skills: Excellent verbal and written communication skills for effective interaction with insurance companies, stakeholders, and staff.

• Problem-Solving: Strong analytical and critical thinking skills to identify and resolve complex claim issues and underpayments.

Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

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Robert Half will consider for employment qualified applicants with arrest or conviction records in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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