Medical Collections Specialist

Position Summary:
We are seeking a detail-oriented and results-driven Medical Claims Collector to join our team. This role is responsible for managing the collections process for outstanding medical claims, including communicating with insurance companies, state portals, and patients to resolve billing issues and secure timely payments. The ideal candidate will have a strong understanding of healthcare billing practices, insurance denials, and collection procedures. 

Key Responsibilities 

• Review, track, and collect outstanding medical claims through state portals, insurance companies, and direct client outreach.
• Research and resolve denied or underpaid claims, ensuring proper resubmission and appeal when necessary.
• Contact patients and clients to arrange payment of outstanding balances in a professional and empathetic manner.
• Communicate with insurance representatives to clarify claim statuses, coverage issues, and payment discrepancies.
• Utilize billing software and electronic health record (EHR) systems to document claim activity, payment arrangements, and collection efforts.
• Maintain accurate records of all collection activity and follow up on aged accounts.
• Collaborate with billing, coding, and administrative teams to resolve claim issues and prevent recurring denials.
• Ensure compliance with HIPAA, federal, and state collection regulations.
• Meet departmental productivity and collections goals.

Qualifications 

• High school diploma or equivalent required; associate degree or certification in medical billing/collections preferred.
• Minimum 2 years of experience in medical collections, medical billing, or claims processing.
• Strong knowledge of state insurance portals, payer systems, and denial management processes.
• Familiarity with medical billing software, EHR systems, and Microsoft Office Suite.
• Excellent communication and negotiation skills, with the ability to interact professionally with patients, insurance representatives, and internal staff.
• Strong organizational skills and attention to detail.
• Ability to work independently, manage multiple priorities, and meet deadlines.

Preferred Skills 

• Experience with appeals and reconsiderations for denied claims.
• Knowledge of CPT, ICD-10, and HCPCS coding basics.
• Bilingual skills (English/Spanish) a plus.

Equal Opportunity Statement: At GA Foods, we are deeply committed to the principles of equal employment opportunity. It is our policy that all employment decisions are made without discrimination based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetics, disability, veteran status, or any other characteristic protected by local, state, or federal law. We base all employment decisions on merit, qualifications to perform the essential job functions (with or without reasonable accommodations), and business needs.GA Foods also provides affirmative action in employment for qualified individuals with disabilities and protected veterans, in compliance with Section 503 of the Rehabilitation Act and the Vietnam Era Veterans' Readjustment Assistance Act.

GA Food Services of Pinellas County, LLC (GA Foods) is proud to be a Drug-Free, Smoke-Free Workplace and an Equal Employment Opportunity Employer.