We are looking for a Medical Collections Specialist to support a high-volume Medicare claims review. This Long-term Contract position focuses on researching billed claims, confirming claim corrections through Medicare portals. The ideal candidate brings strong portal navigation skills, sharp attention to detail, and the ability to manage repetitive claim follow-up work with accuracy and consistency.
Responsibilities:
- Review Medicare claims in multiple payer portals to confirm whether void requests were submitted correctly and completed successfully.
- Investigate specialty claims to verify they were reprocessed under the appropriate tax ID and moved through the claims cycle accurately.
- Validate payment outcomes by checking that reimbursement was issued under the correct billing entity and documenting any discrepancies.
- Maintain detailed tracking logs and spreadsheets to monitor claim status, outstanding items, and resolution progress across a large inventory of accounts.
- Use Medicare administrative contractor portals, including systems such as WPS and Palmetto, to research claim activity and identify next steps.
- Follow repetitive daily workflows with a high level of precision while managing a significant volume of claim reviews.
- Escalate irregular claim findings, unresolved issues, or payment mismatches to the appropriate internal stakeholders for further action.
- Support cleanup efforts related to claims that were previously routed under the wrong tax ID and help drive accurate resolution.
- Coordinate claim follow-up activities during Eastern Time business hours, with some flexibility based on team needs.
- At least 3 years of experience in medical collections, medical billing, or Medicare claims follow-up.
- Advanced working knowledge of Medicare portals and the ability to research claim status independently across multiple systems.
- Experience handling denied, corrected, or appealed medical claims within a revenue cycle environment.
- Strong Excel skills for organizing, updating, and tracking large sets of claim data.
- Ability to reconcile account activity and confirm payment details with a high degree of accuracy.
- Familiarity with medical insurance processes, claims audits, and reimbursement validation.
- Comfort working in a repetitive, detail-heavy role that requires consistent focus and productivity.
- Experience with EMR systems, claims data review, or related revenue management tools is preferred.