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AppleOne
Collections Specialist
Career Insights for Claims Adjuster / Specialist (General)
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Scorecard
Based on Florida data
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What they do
A Claims Adjuster or Specialist investigates and evaluates insurance claims. Specializes in a particular type of insurance. Inspects property damage, including damage to homes, buildings and cars; reviews claims after they are submitted; may authorize or deny payment for claims. May work directly for insurers or on behalf of claimants.
$70,444 / year median in Florida
+6% projected growth
Job Description
Job Summary We are seeking a Healthcare Collections Specialist for a temp-to-hire opportunity in Orlando, FL. This role is ideal for a revenue cycle professional with hands-on experience in insurance collections, denial management, claim corrections, appeals, and reimbursement follow-up. The Collections Specialist will support a high-volume healthcare billing environment with a strong focus on behavioral health, mental health, and substance abuse services. This is not a patient collections or call center collections role. The position is focused on insurance claims, payer denials, appeals, reconsiderations, and AR recovery. This opportunity offers a structured Monday through Friday schedule, steady full-time hours, and the chance to work with a collaborative revenue cycle team. Candidates who enjoy researching complex denials, resolving claim issues, and contributing directly to reimbursement results will be well aligned with this position. Key Responsibilities
- Review EOBs, denial letters, insurance claim details, and payer documentation to determine denial reasons and next steps.
- Prepare and submit appeals, reconsiderations, corrected claims, and supporting documentation within payer deadlines.
- Identify and correct claim issues related to coding, eligibility, medical necessity, documentation, provider information, taxonomy, NPIs, and billing discrepancies.
- Follow up with insurance companies by phone and payer portals to resolve outstanding claims and disputed reimbursement issues.
- Collaborate with Billing, BOS, UR, and internal teams to resolve complex denials, takebacks, recoupments, and AR recovery items.
- Maintain accurate documentation of calls, portal activity, appeals, claim corrections, outcomes, and account resolution progress. Compensation and Benefits
Pay Rate:
$19.00 per hour.Job Type:
Temp-to-Hire.Schedule:
Monday through Friday, 8:00 AM to 5:00 PM.Work Location:
Maitland, FL on siteDress Code:
Business casual. Required Qualifications and Skills- Manage healthcare insurance collections, denial review, appeals, and reimbursement follow-up.
- Research and resolve denied, underpaid, corrected, and outstanding insurance claims.
- Prepare claim corrections, appeal letters, reconsiderations, and payer portal submissions.
- Support monthly production goals of approximately 800 to 1,000 claims.
- 1+ year of healthcare billing, denial management, insurance collections, claims follow-up, or revenue cycle experience required.
- 3 to 5 years of related experience preferred based on role level.
- Experience working with CPT, ICD-10, and HCPCS codes.
- Experience with 837I and/or 837P claim formats.
- Familiarity with UB-04 and/or
CMS-1500
claim forms.- Understanding of insurance reimbursement guidelines, payer requirements, Medicare, Medicaid, and commercial payer processes.
- Ability to read and interpret EOBs, denial letters, medical records, payer policies, and insurance documentation.
- Strong written communication skills for preparing effective appeal letters and claim correspondence.
- High attention to detail with the ability to manage a high-volume, production-focused workload.
- Strong organizational, research, follow-up, and time-management skills.
- Professional communication skills for working with insurance representatives and internal departments. Preferred Qualifications
- Experience with behavioral health, mental health, or substance abuse billing and reimbursement.
- Background in healthcare AR, revenue cycle, insurance verification, reimbursement, appeals, and reconsiderations.
- Experience identifying denial trends and helping reduce future denials.
- Experience supporting takebacks, recoupments, and complex insurance reimbursement reviews.