Medical Insurance Collections Specialist Job in Los Angeles, CA | Robert Half

Key Responsibilities: Perform insurance collections follow-up on outstanding hospital claims with a focus on HMO and PPO payers. Contact insurance companies and payers to obtain claim status, secure payment, and resolve unpaid or underpaid accounts. Review and work hospital UB04 claims to ensure accurate billing and proper reimbursement. Investigate and resolve claim denials, rejections, underpayments, and payment delays. Submit corrected claims, supporting documentation, and appeals as needed to facilitate payment resolution. Follow up on aged accounts receivable and maintain productivity in line with departmental goals. Document all collection activity, account updates, and payer communications in the billing system. Collaborate with billing, coding, and patient financial services teams to resolve claim discrepancies and improve reimbursement outcomes. Monitor payer trends and escalate recurring issues impacting collections.

Qualifications: 3+ years of experience in medical insurance collections, insurance follow-up, or healthcare accounts receivable. Hospital billing or collections experience required. Strong knowledge of HMO and PPO insurance plans, payer guidelines, and reimbursement processes. Experience working with UB04 claims required. Familiarity with denial management, appeals, and claim resolution processes. Strong attention to detail, organizational skills, and ability to manage a high-volume workload. Excellent communication and problem-solving skills. Proficiency with hospital billing systems and electronic medical records preferred.