Medicare Collections Specialist

Job Description

Job Description

Location : The Surgery Center of Huntsville (Huntsville, AL)

Reports To : Collections Team Lead / Business Office Manager

Job Type : Full-Time | Onsite

Position Summary:

The Surgery Center of Huntsville is seeking an experienced and detail-oriented Medicare Collections Specialist to join our Revenue Cycle team at a large, multi-specialty Ambulatory Surgical Facility. This position is responsible for managing the collection of Medicare claims, reducing outstanding balances, and ensuring compliance with Medicare billing and reimbursement policies. The ideal candidate has a strong working knowledge of Medicare processes, is proficient with systems like Waystar, Palmetto GBA, and Availity, and thrives in a high-volume, collaborative environment.

Responsibilities:

• Proactively manage and follow up on outstanding Medicare A/R to ensure timely and accurate reimbursement.
• Investigate and resolve claim denials, rejections, and payment discrepancies via appropriate workflows.
• Submit corrected claims and appeals through portals such as Waystar, Palmetto GBA, and Availity.
• Monitor aging reports and prioritize follow-up based on aging thresholds and financial impact.
• Communicate directly with Medicare representatives to resolve complex billing issues or disputes.
• Collaborate with internal billing, coding, and clinical teams to correct claim errors and expedite payments.
• Accurately document all collection activities in the patient accounting system.
• Maintain up-to-date knowledge of CMS guidelines, NCCI edits, and any payer-specific rules that impact ASC billing.
• Ensure all collection activities are HIPAA-compliant and maintain strict confidentiality of patient and organizational information.
• Assist patients with pre-registration prior to their scheduled procedure to ensure accurate billing information is obtained.
• Confidently assist patients with any billing questions that may arise after the procedure has been completed.

Qualifications:

• Education: High school diploma or equivalent required;
• Experience: Minimum 2 years of Medicare collections experience, preferably in an ASC or surgical specialty setting. Strong understanding of Medicare billing, claims adjudication, and compliance requirements.
• Technical Proficiency:
  • Experience with Waystar, Palmetto GBA, and Availity is required.
  • Proficient in reading and interpreting EOBs, remittance advices, and Medicare policy updates.
  • Familiarity with ASC-specific billing codes (CPT, ICD-10, HCPCS) preferred.
  • Comfortable with MS Excel, Outlook, and EMR/patient accounting systems.

Key Skills & Competencies:

• Strong problem-solving and analytical skills
• Excellent attention to detail and accuracy
• Effective communication and follow-up skills
• Ability to multitask and prioritize in a high-volume, deadline-driven environment
• Team-oriented with a proactive, solutions-focused mindset

Work Environment:

• Onsite position within a large, fast-paced ambulatory surgical center
• Standard business hours; occasional overtime may be required based on volume

What We Offer:

• Competitive compensation
• Comprehensive health, dental, and vision insurance
• 401(k) with employer match
• Paid time off and holidays