Collections Specialist

Description

Provides collections follow-up and denial management support to collect outstanding accounts receivable balances. Complies with payer filing deadlines by utilizing all available resources to resolve held claims. Ensures adherence to all regulatory, contractual, compliance, and Baptist Health South Florida (BHSF) guidelines related to claim billing processes. Communicates with various teams across the organization. Utilizes coding compliance knowledge and understanding of ICD-9, CPT-4, and associated modifiers to resolve claims management issues.

Essential Job Functions
Utilize hospital-based applications and databases to verify and review patient registration information and work assigned tasks to ensure accuracy, support claims processing, and meet productivity standards.
Follow up with appropriate parties to resolve claim data issues and document updates in the system throughout each step of the process.
Ensure and maximize the proper use of available tools to resolve open accounts receivable balances.
Review claims data and supporting documentation submitted for billing to ensure appropriate coding and billing accuracy, including diagnosis and CPT codes.
Prepare appeal letters for denied non-surgical and clinical claims by accessing specific payer appeal forms, optimizing the appeals process, tracking resolution status, and submitting medical documentation in accordance with payer and HIPAA guidelines.
Consider payer contracts when working denials, addressing payment issues, and incorporating billing guidelines.
Report provider credentialing issues and payer-related contractual matters to the appropriate team.
Identify issues affecting reimbursement and escalate them through the appropriate leadership channels.
Remain current on healthcare industry changes through continuing education and ongoing updates to CPT-4, HCPCS, ICD-10, and Revenue Code guidelines as they pertain to billing accuracy.
Utilize Encoder and NCCI guidelines to resolve physician claims.
Understand payer-specific billing and coding guidelines.
Resolve non-surgical and clinical denials.
Perform other duties as assigned.

Marginal Job Functions
Regularly operate a computer and other office equipment to coordinate work activities.
Remain stationary for the majority of the workday.
Frequently communicate with clients and coworkers and effectively share information.
Occasionally stoop, reach, or kneel to access overhead or low cabinets.
Use close visual acuity and computer equipment to prepare, analyze, and transmit data.
Work in an office environment.

Additional Skills & Qualifications

Preferred certifications include one of the following:
- CPC-A (AAPC Certified Professional Coder)
- CCA (AHIMA Certified Coding Associate)
- CCS (AHIMA Certified Coding Specialist)
- CCS-P (AHIMA Certified Coding Specialist - Physician-Based)
- NCIS (NCCT National Certified Insurance Specialist)
Other recognized coding and billing certifications may also be considered.
Excellent verbal and written communication skills, with the ability to effectively communicate with internal and external customers.
Strong computer proficiency, including Microsoft Office (Word, Excel, and Outlook).
Knowledge of physician billing, regulatory requirements, and compliance guidelines.
Knowledge of ICD-10, HCPCS, CPT-4, and related modifiers.
Ability to work under pressure, meet deadlines, maintain a positive attitude, and provide excellent customer service.
Ability to work independently and manage workload to completion.

Minimum Required Experience
2 years experience.

Experience Level

Intermediate Level

Job Type & Location
This is a Contract position based out of South Miami, FL.
Pay and Benefits
The pay range for this position is $24.00 - $25.00/hr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors. Eligibility requirements apply to some benefits and may depend on your job
classification and length of employment. Benefits are subject to change and may be
subject to specific elections, plan, or program terms. If eligible, the benefits
available for this temporary role may include the following:

Medical, dental & vision
Critical Illness, Accident, and Hospital
401(k) Retirement Plan Pre-tax and Roth post-tax contributions available
Life Insurance (Voluntary Life & AD&D for the employee and dependents)
Short and long-term disability
Health Spending Account (HSA)
Transportation benefits
Employee Assistance Program
Time Off/Leave (PTO, Vacation or Sick Leave)
Job Type & Location
This is a Contract position based out of South Miami, FL.
Application Deadline
This position is anticipated to close on Nov 6, 2026.
Workplace Type
This is a fully onsite position in South Miami,FL.

About Aston Carter

Aston Carter provides world-class corporate talent solutions to thousands of clients across the globe. Specialized in accounting, finance, human resources, talent acquisition, procurement, supply chain and select administrative professions, we extend the capabilities of industry-leading companies. We draw on our deep recruiting expertise and expansive network to meet the evolving needs of our clients and talent community with agility and excellence. With offices across the U.S., Canada, Asia Pacific and Europe, Aston Carter serves many of the Fortune 500. We are proud to be a ClearlyRated Best of Staffing® Platinum Award winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email [email protected] for other accommodation options.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.