Job Details

Medical Insurance Collections Specialist The Insurance/Collections Specialist is responsible for identifying, analyzing, and recovering overpaid medical claims from healthcare providers, third parties, and insurance carriers. This role includes resolving discrepancies related to coordination of benefits (COB), duplicate payments, and other claim errors through research, communication, and follow-up.
This position requires managing a high volume of calls, maintaining positive provider relationships, and ensuring timely resolution of accounts while meeting performance standards for collections, compliance, and productivity.
Key responsibilities include:
Recover medical claim overpayments through phone, email, and fax outreach
Analyze claims data to identify overpayments and determine recovery actions
Handle provider disputes, appeals, and complex collection scenarios
Coordinate with clients and providers to process adjustments and reversals
Maintain accurate follow-ups to ensure timely resolution
Develop effective collection strategies to maximize recovery
Communicate clearly with internal teams and external partners
Required experience and knowledge:
Minimum 2 years of medical billing and/or insurance collections experience and account management
Strong understanding of:
Medical claims processing and reimbursement
Medicare (Parts A, B, C, D), Medicaid, and commercial insurance
Coordination of Benefits (COB)
Claim denials, appeals, and rebilling processes
Explanation of Benefits (EOB) and Electronic Remittance Advice (ERA)
CPT and ICD-9/10 coding
Healthcare settings (inpatient, outpatient, pharmacy, etc.)
Ability to identify and explain overpayment types (duplicates, contractual, PPO, bundled claims, etc.)
Skills and requirements:
Must be able to successfully complete a background check and drug screening
Associate degree or equivalent combination of education and experience
Strong analytical, organizational, and problem-solving skills
Excellent verbal and written communication
Ability to manage high call volume and work independently
Proficiency in Microsoft Office (Word, Excel, Outlook)
Strong customer service and negotiation skills
Requirements:
Must pass an internet speed test (download equal to or greater than 25, upload equal to or greater than 5, Ping ms equal to or less than 175 )
Must have the ability to connect with an ethernet cable to a modem/router
Live in one of the following states, AL, AR, AZ, CO CT, DE, FL, GA, ID, IN, IA, KS, KY, LA, ME, MI, MS, MO, NE, NV, NH, NJ,NM, NC, OH, OK, PA, RI, SC, SD, TN, TX,UT, VT, VA, WA, WV, WI, WY
We are currently NOT hiring in the following geographies, included but not limited to: States: AK, CA, CT, HI, MA, IL, MT & NY Metro Areas: MN Minneapolis, IL Chicago, NY New York City, OR - Portland, MD - Montgomery County, WA - Seattle, Washington, Washington DC
Due to varying state and local minimum wage laws, we are currently only able to hire candidates residing in states where our compensation structure complies with applicable wage regulations. As a result, we may be unable to consider applicants from certain states or municipalities at this time.
Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated hourly rate is $18.00.
Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.
For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form. Complete the form and then email it as an attachment to ...@conduent.com. You may also click here to access Conduents ADAAA Accommodation Policy.