Medical Collections Specialist

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

📋 Description

• Follow up on submitted insurance claims to guarantee accurate and prompt reimbursement.

• Manage designated payer accounts and address outstanding balances until resolved.

• Investigate denied, underpaid, and unpaid claims to determine the appropriate next steps.

• Communicate directly with insurance payers to rectify claim issues and secure reimbursements.

• Identify claims that require correction, reconsideration, appeal, or rebilling.

• Review payer contracts, coverage prerequisites, and reimbursement methodologies.

• Collaborate with billing, pharmacy, and operations teams to address reimbursement challenges.

• Respond to internal and external inquiries regarding the status of claims.

• Maintain accurate documentation of collection activities and payer follow-up.

• Stay updated on billing regulations, coding standards, and changes in payer policies.

• Utilize clearinghouses and billing systems to enhance collections workflows.

• Assist with reporting, data entry, and other revenue-cycle tasks as necessary.

• Uphold accuracy, professionalism, and consistent follow-through across assigned accounts.

⛳️ Requirements

• High school diploma or GED.

• At least 3 years of experience in medical collections or a related revenue-cycle role.

• Experience in communicating with insurance payers and resolving outstanding claims.

• Proven track record of providing customer service to both internal and external stakeholders.

• Basic proficiency in Microsoft Office, including Word, Excel, and PowerPoint.

• Strong analytical and problem-solving abilities.

• Persistence and confidence in following up with insurance payers.

• Excellent attention to detail and commitment to follow-through.

• Customer-service orientation balanced with financial accountability.

• Ability to perform effectively in a fast-paced, metrics-driven setting.

• Strong written and verbal communication skills.

• Ownership of assigned accounts with a proactive approach to resolving claims.

• Preferred: 5+ years of experience in medical collections.

• Preferred: Previous experience in home infusion, specialty pharmacy, or infusion therapy billing/collections.

• Preferred: Background in handling insurance denials, underpayments, appeals, and payer follow-up.

• Preferred: Familiarity with healthcare billing platforms, clearinghouses, or revenue-cycle systems.

• Participate annually in mandatory legal and ethical compliance training.

• Act in accordance with LUX Infusion’s legal, ethical, and compliance policies.

• Adhere to the standards and procedures outlined in the LUX Infusion Compliance Manual.

• Capability to prioritize competing demands and effectively manage multiple tasks.

🏝️ Benefits

• Purpose-driven work that directly supports patient access to care.

• Patient-first, clinician-led culture.

• Strong collaboration across revenue cycle, pharmacy, clinical, and operations teams.

• Consistent Monday–Friday schedule.

• Clear expectations and opportunities for professional growth.

• Potential hybrid eligibility after six months based on performance and business needs.