Medical Collections Specialist

Medical Collections Specialist

Join Butterfly Effects, a national ABA-informed therapy provider, and become a Medical Collections Specialist. This role is vital in ensuring accurate, timely collection and resolution of outstanding payer balances while providing exceptional service to families across the country. As a Medical Collections Specialist, you will support our national collections efforts with a focus on accuracy, professionalism, and responsiveness. You'll manage assigned accounts, research and resolve denied or underpaid claims, and maintain compliance with payer guidelines and HIPAA regulations. This role requires a highly organized and detail-oriented individual with strong problem-solving skills and a collaborative mindset.

Key responsibilities include :

• Verify client demographics, authorizations, CPT codes, and claim details related to denials or underpayments.
• Research claims using insurance portals, Central Reach, and EOBs to determine resolution paths.
• Review clearinghouse activity for denials and manage resubmissions or corrections.
• Collaborate with the billing team to correct and resubmit denied claims due to billing errors.
• Identify timesheet, coding, or documentation issues, and escalate for resolution.
• Track and report payer trends, recurring denials, or discrepancies; recommend action plans to management.
• Respond to incoming calls and correspondence from payers regarding account status.

Qualifications :

About Butterfly Effects : Since 2005, Butterfly Effects has supported over 14,000 families through our compassionate, family-centered ABA therapy. Our mission is to partner with families affected by autism to help children live more joyful, independent lives. Our name and butterfly logo symbolize transformation, growth, and love-core values that guide everything we do.