Collections Specialist - Revenue Cycle Management

Vital Care Infusion Services•Jacksonville, FL

5h•$19 - $23•Remote

About The Position

Vital Care is seeking a Collections Specialist to join their Revenue Cycle Management team. This role focuses on collecting Home Infusion claims with accuracy and timeliness to reduce denial rates, DSO, and bad debt. The specialist will identify revenue opportunities and improve collection rates while adhering to standard practices. The position is 100% remote.

Requirements

Excellent communication skills (listening, speaking, understanding, and writing English) to influence patients, caregivers, payer representatives, and others.
Proven understanding of processes, systems, and techniques for successful billing and collection with all payer types.
Proven ability to identify gaps and problems from documentation review, determine lasting solutions, make effective decisions, and take necessary corrective action.
Strong organization skills with the ability to track and maintain clear, complete records of activities, cases, and related documentation.
Proven knowledge and skill in the utilization of MS Office suite of software and pharmacy applications.
Ability to complete job duties in a designated workspace outside the dedicated RCM location.
Disciplined work ethic with the ability to work remotely with minimum direct supervision to meet production and collection targets.
2-5 years of home infusion billing and/or collections experience required.
High School Diploma and additional specialized training in intake, pharmacy/medical billing, and/or collections.
Must be authorized to work in the United States and perform work from within the United States.

Nice To Haves

Previous remote work environment experience is a plus.
Detailed oriented with post-billing and post-payment investigative experience preferred.

Responsibilities

Review claims with outstanding balances and identify actions to collect revenues.
Follow up with insurers and patients to collect outstanding balances, focusing on building customer and business relationships.
Utilize Payer Portals via the internet for claim disposition.
Review documents such as Explanations of Benefits (EOBs) and Remittance Advices (RAs) to identify reasons for denials.
Take required corrective action for denials and own claims through to successful collection.
Analyze denials, identify trends, and recommend process improvements to reduce DSO, improve collection rates, reduce bad debt, and simplify processes.
Identify payor requirements for submitting appeals for denied claims.
Verify insurance information with patients, order medical records, review original claim coding, compile necessary documentation, and submit appeals.
Communicate effectively with franchise partners and other VCI departments regarding collection status.
Resolve payer issues/concerns in a timely manner.
Document case activity, communications, and correspondence in the computer system.
Schedule follow-ups at required intervals.
Investigate and verify benefits for pharmacy and medical third-party claims.
Communicate billing problems found during the collection process to prevent future issues.
Communicate financial obligation information with patients clearly.
Contribute medical billing expertise to the design of training and knowledge transfer programs, materials, policies, and procedures.
Assist with processing online adjudication of collection issues and nurse billing as assigned.
Perform other related duties as assigned.