Collections Associate

This is a fully remote position, open to applicants in United States.

📋 Description

• Conduct follow-ups on unpaid and aging insurance claims with payers via phone and electronic methods.

• Analyze and review claim issues, rejections, denials, and outstanding balances to establish suitable resolution strategies.

• Submit new claims and resubmit existing claims along with necessary supporting documentation to payers as needed.

• Examine payments and Explanations of Benefits (EOBs) to determine next steps for denied or unresolved claims, including appeals, resubmissions, additional documentation, or patient billing.

• Prepare and submit appeals along with supporting documentation in line with payer requirements.

• Investigate payer underpayments and discrepancies, ensuring they are resolved appropriately.

• Post payments and accurately input EOB information into the billing system.

• Verify and maintain precise patient, insurance, payer, and claim information within billing and CRM systems.

• Prepare and disseminate patient billing statements.

• Communicate with patients concerning outstanding balances, financial obligations, and available payment options.

• Arrange reasonable payment plans with patients in compliance with company policies.

• Accurately process patient payments, refunds, and adjustments following established procedures.

• Address inquiries from patients and providers regarding billing statements, insurance claims, payment statuses, and outstanding balances.

• Maintain thorough and accurate documentation of collection activities, payer communications, payments, claim statuses, and correspondence.

• Generate and support accounts receivable (AR) and aging reports, assisting with broader revenue cycle management tasks.

• Collaborate with Finance and internal stakeholders regarding patient orders, claims status, and outstanding balances.

• Independently oversee assigned collections activities while meeting expectations for productivity, accuracy, and follow-up.

• Identify recurring denial, payment, or collections challenges and escalate trends or opportunities for process improvement.

• Ensure compliance with HIPAA, relevant billing regulations, payer requirements, and company policies.

⛳️ Requirements

• 1–3 years of experience in medical billing, collections, claims, insurance processing, revenue cycle management, or a related healthcare function.

• Knowledge of medical insurance claim submission and resubmission processes, as well as denials, appeals, and reimbursement procedures.

• Experience in reviewing EOBs and identifying suitable next steps for unpaid, denied, rejected, or underpaid claims.

• Familiarity with medical terminology and health insurance language.

• Proven experience communicating with insurance payers regarding outstanding claims and reimbursement matters.

• Background in patient support, customer service, or customer care roles.

• Ability to communicate professionally and with empathy to patients regarding their financial responsibilities and outstanding balances.

• Strong attention to detail with the capability to maintain accurate billing and collections documentation.

• Skill in independently investigating issues, determining appropriate next steps, and guiding claims to resolution.

• Excellent organizational skills with the ability to manage multiple claims, deadlines, and priorities in a fast-paced setting.

• Proficient written and verbal communication skills.

• Capability to effectively de-escalate and resolve challenging interactions with patients or payers.

• Ability to collaborate efficiently with a remote and cross-functional team.

• Preferred: Experience with reimbursement and claims processes for UnitedHealthcare, Aetna, and/or Blue Cross Blue Shield.

• Preferred: Background in DME, medical device, or other healthcare reimbursement fields.

• Preferred: Experience in preparing and submitting insurance appeals.

• Preferred: Experience investigating payer underpayments.

• Preferred: Familiarity with AR aging and revenue cycle reporting.

• Preferred: Knowledge of NikoHealth, Salesforce, Microsoft applications, or similar CRM and medical billing systems.

• Preferred: Experience in a startup, high-growth, or rapidly evolving healthcare environment.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health, dental, and vision insurance.

• Opportunities for professional development and career advancement.

• Flexible work hours and remote work options.

• Supportive and collaborative work environment.