Healthcare Collections Specialist – RCM

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

📋 Description

• Maintain communication with insurance providers via payer portals and phone inquiries to ascertain claim status and ensure proper reimbursement.

• Investigate payment discrepancies, identify underlying issues, and implement corrective measures for denied and underpaid claims.

• Provide necessary documentation for reconsiderations and appeals while adhering to payer guidelines and timelines.

• Analyze explanations of benefits, denial codes, and billing information to determine subsequent actions.

• Collaborate with revenue cycle team members to rectify billing, benefits, or authorization mistakes and recognize denial patterns.

• Record follow-up activities, respond to payer communications, and maintain updated accounts.

• Achieve set productivity and quality benchmarks while managing assigned accounts.

⛳️ Requirements

• Prior experience in medical billing and insurance collections, including professional billing.

• Proven experience in resolving denied and underpaid claims through the process of reconsiderations and appeals.

• Familiarity with Medicare, Medicaid, and commercial insurance regulations.

• Proficient understanding of CPT, HCPCS, and ICD-10 coding.

• Capability to interpret EOBs and insurance denial reason codes.

• Strong skills in research, problem-solving, and both written and verbal communication.

• Ability to prioritize accounts, meet deadlines, and work autonomously in a remote environment.

• A collaborative mindset and eagerness to learn and implement feedback.

• Previous experience with infusion billing or insurance collections is preferred.

• Must possess legal authorization to work in the United States.

• Must not require sponsorship, either now or in the future, to work in the United States.

🏝️ Benefits

• Comprehensive health, dental, and vision insurance.

• Retirement savings plan with employer matching contributions.

• Flexible work hours and remote work opportunities.

• Ongoing professional development and training programs.

• Generous paid time off and holiday leave.