Sr. Patient Account Specialist
Posted: 05/18/2026
Job Number: 22463
Job Description
Position Summary
We are seeking an experienced Patient Account Specialist Lead to support medical collections and revenue cycle operations for healthcare accounts. This role is responsible for resolving outstanding patient accounts, managing collection activities, and ensuring compliance with healthcare billing and collection regulations.
The ideal candidate will have a strong background in medical collections, Medicare billing, hospital A/R, and government insurance follow-up, along with excellent communication and analytical skills. This position interacts with patients, insurance carriers, internal teams, and external partners to drive timely account resolution and maximize recoveries.
Key Responsibilities
Medical Collections & Account Resolution
- Manage and resolve assigned patient accounts through effective collection activities and follow-up efforts
- Perform collections on government and third-party payer accounts while adhering to all applicable state and federal regulations
- Ensure accurate and timely documentation of account activity within collection systems
- Handle inbound calls from patients, insurance carriers, and external partners professionally and efficiently
- Research and resolve account discrepancies, denials, payment variances, and claim issues
- Validate claim payments to ensure reimbursement aligns with contract and payment methodology guidelines
- Meet or exceed established productivity, quality, and recovery goals
Government Insurance & Medicare Support
- Maintain working knowledge of Medicare/Medicaid billing, collections, appeals, and reimbursement guidelines
- Process Medicare Redeterminations, Reopenings, and Reconsiderations as needed
- Correct claims in RTP status according to Medicare guidelines
- Support recovery audit and appeals processes related to government insurance claims
- Research and reference CMS and Medicare regulations when resolving account issues
Collaboration & Customer Service
- Partner with internal departments to obtain documentation needed for appeals and claim resolution
- Promote positive patient and client relationships through professional and respectful communication
- Ensure compliance with organizational policies and healthcare industry regulations
- Assist with special projects and operational initiatives as assigned
Qualifications
Required Experience
- 5–7 years of experience in:
- Medical collections
- Healthcare revenue cycle
- Hospital accounts receivable (A/R)
- Government insurance follow-up
- Experience with Medicare billing processes and appeals
Preferred Background
- Previous experience with:
- Medicare/Medicaid collections
- Recovery Audit Contractor (RAC) processes
- Insurance claims processing
- Healthcare billing systems and collections software
Technical Skills
- Strong understanding of:
- CMS regulations
- Medical billing and reimbursement practices
- Appeals and denials management
- Proficiency with Microsoft Office, including Word and Excel
- Strong analytical, organizational, and communication skills
Education
- College coursework, healthcare billing certification/training, or insurance claims experience may be considered in lieu of direct hospital experience
Meet Your Recruiter
Share This Job:
Related Jobs:
Login to save this search and get notified of similar positions.About Houston, TX
Discover exciting job opportunities in the vibrant region around Houston, Texas! Known for its thriving economy, diverse industries, and endless growth prospects, Houston offers an enticing landscape for career-minded individuals. With world-class museums like the Museum of Fine Arts and a rich culinary scene showcasing Tex-Mex delights, BBQ joints, and food trucks serving up local flavors, Houston is a melting pot of culture and creativity. Home to the renowned Space Center Houston, the historic Astrodome, and professional sports teams like the Rockets and the Astros, this region exudes energy and excitement. Embrace the charm of this dynamic area while exploring job listings that could lead you to a fulfilling career right here in Houston!