The Medicare Collections & Recoupment Specialist manages Medicare accounts receivable, focusing on payment takebacks, recoupments, and demand letters issued by Medicare. This role ensures timely response to Medicare payment adjustments and appeal determinations related to wound care services. The specialist works closely with billing, coding, clinical, and compliance teams to protect revenue while maintaining compliance with CMS and MAC requirements.
Responsible for collections and appeals from various Federal, State, & Third Party (HMO, PPO, IPA, TPA Indemnity) payers.
Optimize payment reimbursements by reviewing accounts for billing accuracy and health plan coverage.
Process an appeal, resubmit/rebill, or forward claims for adjudication as necessary.
BillionToOne is a next-generation molecular diagnostics company on a mission to make powerful, accurate diagnostic tests accessible to everyone. Forbes recently named them one of America's Best Startup Employers for 2025, and they were awarded Great Place to Work certification in 2024.
In this position, you will be responsible for handling a variety of tasks to ensure payment collection activity is resolved, disputed, or sent to Legal. Conduct collection activity on appealed claims by contacting government agencies, third party payers via phone, email, or online. Communicate with insurance plans and researching health plans for benefits and types of coverage.
Sutherland is a digital transformation company helping customers globally achieve greater agility and transform automated customer experiences for over 35 years.
The Insurance Reimbursement Specialist maximizes reimbursement by collecting outstanding balances from insurance companies. The Specialist follows up on unresolved claims and escalates claims for reconsiderations. The Specialist works with CareDx Payer Dispute Resolution/Market Access teams ensuring proper reimbursement from payers.
CareDx, Inc. is focused on the discovery, development, and commercialization of clinically differentiated, high-value healthcare solutions for transplant patients.
The Senior Payer Accounts Receivable Specialist drives payer reimbursement performance and ensures timely, accurate claim resolution. This individual will oversee the payer accounts receivable process across multiple states. This role requires knowledge of healthcare payer operations, denial management, and reimbursement trends.
knownwell is a weight-inclusive healthcare company offering metabolic health services, primary care, nutrition counseling and health coaching services.
Maintain comprehensive billing records, monitor and report key performance indicators related to claims submission, denial resolution, and payment posting.
Serve as the primary point of contact for internal teams and external payers.
Apollo Behavior is the premier provider of ABA therapy in metro Atlanta, and the largest ABA provider based in Georgia.
Process transactions on insurance accounts and interact with insurance companies.
Communicate with staff and third-party customers to ensure accurate processing.
Prioritize accounts to maximize aged AR resolution, and research documentation.
Oregon Health & Science University values a diverse and culturally competent workforce. They are proud of their commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status.