Collections Specialist - RCM

Vital Care Infusion Services•Tucson, AZ

19h•Remote

About The Position

Vital Care is hiring a remote Collections Specialist to collect Home Infusion claims, emphasizing accuracy, timeliness, and adherence to processes that reduce denials, days sales outstanding (DSO), and bad debt. The role also identifies additional revenue opportunities and works to improve collection rates while performing revenue cycle collection duties within standard or accepted practice limits. The position is 100% remote and full-time. The Collections Specialist reviews outstanding claims, follows up with insurers and patients, uses payer portals, evaluates remittance and denial documents, and takes ownership of claims through resolution and collection. The role investigates benefits and billing issues, prepares and submits appeals, maintains complete account documentation, communicates financial obligations to patients, and collaborates with franchise partners and internal departments. The specialist also analyzes denial trends, recommends process improvements, contributes billing expertise to training and procedures, and assists with online adjudication and nurse billing as assigned.

Requirements

2–5 years of home infusion billing and/or collections experience.
High school diploma and additional specialized training in intake, pharmacy or medical billing, and/or collections.
Excellent English communication skills, including listening, speaking, comprehension, and writing, with the ability to influence patients, caregivers, payer representatives, and others.
Demonstrated understanding of billing and collection processes, systems, and techniques across payer types.
Ability to identify gaps and problems through documentation review, determine lasting solutions, make effective decisions, and take corrective action.
Strong organizational skills and ability to maintain clear, complete records of activities, cases, and related documentation.
Knowledge and skill using Microsoft Office software and pharmacy applications.
Ability to perform duties in a designated workspace outside the dedicated RCM location.
Disciplined work ethic and ability to work remotely with minimal direct supervision while meeting production and collection targets.

Nice To Haves

Previous experience in a remote work environment.
Detail-oriented, with post-billing and post-payment investigative experience.

Responsibilities

Review claims with outstanding balances and identify actions to collect revenue.
Follow up with insurers and patients to collect outstanding balances while building customer and business relationships.
Use payer portals to check claim disposition.
Review EOBs, remittance advices, and other documents indicating claim acceptance or denial.
Identify denial reasons, take corrective action, and manage claims through timely collection.
Analyze denial trends and recommend process improvements to reduce DSO and bad debt and improve collection rates.
Identify payer appeal requirements; verify insurance information, order medical records, review claim coding, compile supporting documentation, and submit appeals.
Communicate collection status to franchise partners and other VCI departments, and resolve payer issues and concerns in a timely manner.
Document case activity, communications, and correspondence in the computer system, and schedule follow-ups at required intervals.
Investigate and verify benefits for pharmacy and medical third-party claims.
Communicate billing problems identified during collection work to help prevent recurrence.
Explain patients’ financial obligations so they understand therapy costs before services begin.
Contribute medical billing expertise to the development of training, knowledge-transfer programs, materials, policies, and procedures.
Assist with online adjudication of collection issues and nurse billing as assigned.
Perform other related duties as assigned.

Benefits

Comprehensive medical, dental, and vision plans.
Flexible spending and health savings accounts.
Paid time off, personal days, and company-paid holidays.
Paid paternal leave.
Volunteerism days off.
Company-sponsored basic life insurance and long-term disability insurance.
Voluntary life, accident, critical illness, and short-term disability insurance.
401(k) matching.
Tuition reimbursement.
Employee assistance programs covering mental health, financial, and legal support.
Medical-carrier rewards programs.
Professional development and growth opportunities.
Employee referral program.