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How much do medicare collection specialist jobs pay per hour?

As of Aug 2, 2026, the average hourly pay for medicare collection specialist in the United States is $21.46, according to ZipRecruiter salary data. Most workers in this role earn between $17.79 and $24.04 per hour, depending on experience, location, and employer.

What do Medicare specialists do?

Medicare Collection Specialists handle billing, claims processing, and reimbursement for Medicare services. They verify patient eligibility, ensure compliance with regulations, and work with insurance providers to resolve payment issues, often using healthcare management software. Strong knowledge of Medicare policies and attention to detail are essential for this role.

What are the key skills and qualifications needed to thrive as a Medicare Collection Specialist, and why are they important?

To thrive as a Medicare Collection Specialist, you need strong knowledge of medical billing, Medicare regulations, and claims processing, often supported by experience in healthcare administration or certification such as Certified Professional Biller (CPB). Familiarity with billing software, electronic health records (EHR) systems, and claims management platforms is typically required. Attention to detail, problem-solving, and effective communication skills help ensure accurate claim submission and resolution of payment discrepancies. These skills are crucial for maximizing reimbursement, maintaining compliance, and supporting the financial health of healthcare organizations.

What is the highest paying collection job?

In the field of collections, senior or specialized roles such as Collections Manager or Recovery Director tend to have the highest salaries, often exceeding $70,000 annually. These positions typically require extensive experience, strong negotiation skills, and knowledge of industry regulations, including Medicare or healthcare collections if applicable.

What are Medicare Collection Specialists?

Medicare Collection Specialists are professionals who manage and collect payments related to Medicare insurance claims. They work with healthcare providers, insurance companies, and patients to ensure that claims are processed correctly and outstanding balances are collected in a timely manner. Their duties include reviewing patient accounts, resolving billing discrepancies, submitting appeals for denied claims, and communicating with both Medicare representatives and patients. By efficiently handling these tasks, they help healthcare organizations maintain financial stability and compliance with Medicare regulations.

How does a Medicare Collection Specialist typically interact with other departments to resolve outstanding claims?

As a Medicare Collection Specialist, you will regularly collaborate with billing, coding, and patient services teams to resolve outstanding claims. Coordination with coders helps clarify any discrepancies in medical coding, while working with billing staff ensures that claims are submitted accurately and on time. You may also communicate with insurance representatives to gather additional information or appeal denied claims. This teamwork-oriented environment requires strong communication skills and attention to detail to ensure prompt reimbursement and compliance with Medicare regulations.

What skills do you need to be a collection specialist?

A Medicare Collection Specialist needs strong communication and negotiation skills to interact effectively with patients and providers. Attention to detail, knowledge of billing and coding procedures, and proficiency with collection software or databases are also essential for managing accounts and ensuring accurate payments.

Is collection specialist a stressful job?

A Medicare Collection Specialist role can be stressful due to the need for accuracy, meeting deadlines, and handling difficult conversations with patients or insurance companies. The job often requires strong organizational skills and attention to detail, but workload and workplace environment also influence stress levels. Proper training and support can help manage job-related stress effectively.

What is the difference between Medicare Collection Specialist vs Medical Billing Specialist?

AspectMedicare Collection SpecialistMedical Billing Specialist
CredentialsKnowledge of Medicare policies, certifications may include medical billing or codingMedical billing or coding certifications often required
Work EnvironmentHealthcare facilities, insurance companies, or billing companiesHospitals, clinics, or healthcare offices
Employer & IndustryPrimarily in healthcare and insurance sectorsHealthcare providers and billing services
Search & Comparison IntentFocuses on Medicare-specific collections and regulationsBroader medical billing processes across insurance types

The Medicare Collection Specialist primarily handles Medicare-specific billing and collections, requiring knowledge of Medicare policies. In contrast, the Medical Billing Specialist manages billing for various insurance types, including private and government plans. While both roles involve billing and coding, the Medicare Collection Specialist specializes in Medicare regulations and claims, making it essential for those working specifically with Medicare reimbursements.

More about Medicare Collection Specialist jobs
What job categories do people searching Medicare Collection Specialist jobs look for? The top searched job categories for Medicare Collection Specialist jobs are:
Medicare Collection Specialist jobs near you
Infographic showing various Medicare Collection Specialist job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $44,646 per year, or $21.5 per hour.

Inpatient Medicare Collection Specialist

TaraVista Behavioral Health

Devens, MA • On-site

$20.50 - $27.75/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 24 days ago

Job description

Join Us as Inpatient Medicare Collections Specialist!
Full Time 40 hours onsite in Auburn, MA
The Inpatient Medicare Collections Specialist is responsible for maximizing reimbursement and ensuring timely resolution of Medicare inpatient accounts receivable. This role focuses on Medicare fee-for-service claims, including high-dollar hospital stays, by managing claim edits, resolving denials, and navigating the Medicare Direct Data Entry (DDE/FISS) system to secure accurate and timely payment.
Inpatient Medicare Collections Specialist Job Responsibilities:
  • Monitor Medicare DDE (FISS) system for claim status updates including edits, RTP, and suspended claims.
  • Correct claim errors, billing discrepancies, and coding-related issues.
  • Investigate and resolve denied, zero-pay, or underpaid Medicare claims.
  • Prepare and submit redetermination and reconsideration appeals.
  • Work Medicare aging reports daily and prioritize high-dollar accounts.
  • Communicate with Medicare Administrative Contractors (MACs) to resolve claim issues.
  • Coordinate patient responsibility and secondary billing.
  • Ensure compliance with CMS regulations and proper documentation.
  • Other Collections activity as assigned

Inpatient Medicare Collections Specialist will have the following:
  • 1-3+ years of hospital billing or Medicare collections experience.
  • Inpatient Psych experience preferred.
  • Experience with Medicare DDE/FISS preferred.Knowledge of Medicare billing rules and IPPS
  • Familiarity with Medicare Secondary Payer (MSP) rules
  • Strong analytical and detail-oriented skills
  • Proficiency in billing systems and Microsoft Office

When you join the growing TaraVista team, you're not just taking a job, you're making a difference in people's lives.As our team member, you'll receive:
  • Medical, Dental, and Vision
  • 401(k) match
  • Employer paid short term disability (STD)
  • Employer paid life and AD&D Insurance
  • Generous Paid Time Off
  • Flexible Spending Account
  • Tuition Reimbursement

Pay Range
Compensation will be determined based on the candidate's relevant experience.
$24.00 - $30.00
TaraVista is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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