SCP Health is hiring a Medical Collection Specialist to support reimbursement, denial management, and claims resolution for emergency room and hospital medicine services. The role focuses on reviewing accounts receivable by payer, preparing appeals, resolving denials, and improving reimbursement outcomes while maintaining quality and production standards.
- Review accounts receivable by payer to maintain or improve reimbursement goals and days in AR.
- Prepare and submit timely appeals for medical necessity and other denials.
- Identify root causes of non-payment, including coding, billing, documentation, and compliance issues.
- Collaborate with coding and billing teams to resolve denial trends and prevent future issues.
- Maintain high productivity and quality standards, including QA audit performance.
- Provide feedback on payer behavior, adjudication concerns, and denial trends.
Requirements & Qualifications
- High school diploma or equivalent.
- 2+ years of experience in medical insurance denials management.
- 2+ years of experience in customer service and patient billing within the medical industry.
- Experience reading EOBs for government, commercial, PPO, HMO/IPA, and workers' compensation payers.
- Knowledge of ICD-9, ICD-10, CPT, HCPCS, and general claims processing practices.
- Ability to review credits, recoupment demands, patient liability, coinsurance, deductibles, and denial codes.
- Strong written and verbal communication skills.
- Strong organizational, interpersonal, and problem-solving skills.
- Proficiency with MS Office, especially Excel and Word.
- Experience with OnBase, Centricity, Waystar, and payor portals preferred.
Benefits & Perks
- Comprehensive benefits package.
- Medical, dental, and vision insurance.
- 401(k) with company match.
- Paid time off and holidays.
- Professional development support.
- Employee wellness resources.
- Strong work/life balance.
- Inclusive workplace culture.
Location
Dallas, Texas, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
3 weeks ago
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