Collections Specialist

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

📋 Description

• Oversee and manage accounts receivable for pharmacy and AIC infusion services assigned to you.

• Address denied, rejected, and underpaid claims to maximize reimbursement outcomes.

• Communicate with insurance payers to resolve claim-related issues, verify the status of claims, and ensure payment is secured.

• Analyze Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs) to spot discrepancies.

• Investigate and rectify billing mistakes, coding issues, and authorization-related denials.

• Prepare and submit appeals along with necessary supporting documentation as required.

• Monitor aging reports and prioritize accounts based on timely filing limits and the potential impact on reimbursement.

• Collaborate with billing, coding, intake, and clinical teams to address claim-related challenges.

• Identify trends in denials or payer behavior and escalate systemic issues as needed.

• Keep precise records of all collection activities within the system.

• Ensure adherence to payer requirements, HIPAA regulations, and company policies.

• Assist with patient inquiries regarding account balances and payment arrangements, when applicable.

• Contribute to month-end reporting and accounts receivable reconciliation tasks.

⛳️ Requirements

• A high school diploma or equivalent is required.

• 1–2 years of experience in medical collections is preferred, particularly in specialty pharmacy or infusion services.

• Familiarity with infusion billing, specialty drug reimbursement, and HCPCS/J-codes is preferred.

• Strong knowledge of payer guidelines, appeals processes, and denial management practices.

• Experience with EHR/Practice Management systems such as WeInfuse, CareTend, Brightree, or similar platforms.

• Proficient in Microsoft Excel and reporting tools.

• Strong analytical and problem-solving abilities.

• Excellent communication and negotiation skills.

• Attention to detail and a commitment to accuracy.

• Ability to handle a high-volume workload while meeting deadlines.

• Critical thinking skills and determination in resolving complex claims.

• Team-oriented yet capable of working independently.

• A bachelor's degree or relevant experience is preferred.

• License requirement: N/A

🏝️ Benefits

• Health

• Dental

• Vision

• Life

• 401k

• Paid Time Off