Collections Specialist II, Home Infusion

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

📋 Description

• Oversee billing and collections activities involving third-party entities

• Analyze and resolve issues related to claim denials, rejections, and underpayments

• Prepare payer appeals and ensure timely follow-up on them

• Evaluate claims, EOBs, and patient accounts to establish the appropriate course of action

• Adjust and resubmit claims for reimbursement as needed

• Record efforts and actions taken during the collection process on accounts

• Liaise with payers, patients, and internal teams to clear outstanding accounts

• Uphold quality, productivity, and compliance standards in all tasks

• Carry out additional responsibilities as assigned

• Provide support to CarepathRx within the Pharmacy and Care Delivery division of Evernorth Health Services

⛳️ Requirements

• High school diploma or equivalent qualification

• A minimum of 3 years of experience in medical collections, billing, or healthcare revenue cycle

• Familiarity with insurance reimbursement, claim processing, and payer guidelines

• Preferred understanding of ICD-10, CPT, HCPCS, and medical terminology

• Experience in home infusion, Medicare, or DME billing is preferred

• Excellent problem-solving, organizational, and communication abilities

• Capacity to work independently, prioritize multiple tasks, and pay attention to detail

• Proficiency in Microsoft 365 applications (Outlook, Teams, Excel)

• For remote work, a reliable internet connection through a cable broadband or fiber optic provider with at least 10Mbps download and 5Mbps upload speed is required

🏝️ Benefits

• Eligibility for an annual bonus plan

• Comprehensive medical insurance

• Vision insurance coverage

• Dental insurance options

• Programs for well-being and behavioral health

• 401(k) retirement plan

• Life insurance provided by the company

• Tuition reimbursement program

• Minimum of 18 days of paid time off each year

• Paid holidays

• Leave of absence provisions

• Requirement for a cable broadband or fiber optic internet service with at least 10Mbps download and 5Mbps upload for remote working