Collections Specialist - Revenue Cycle Management

Vital Care Infusion Services•Oklahoma City, OK

8d•Remote

About The Position

Vital Care is hiring a full-time, 100% remote Collections Specialist for its Revenue Cycle Management team. The role collects Home Infusion claims, emphasizing accuracy, timeliness, and adherence to processes that reduce denials, days sales outstanding (DSO), and bad debt. The specialist identifies revenue opportunities, improves collection rates, and performs revenue cycle collection work within standard or accepted practice limits. The position involves reviewing outstanding claims, following up with insurers and patients, investigating denials, preparing appeals, verifying benefits, resolving payer issues, and documenting account activity. The specialist works with franchise partners and internal departments, helps communicate patient financial obligations, and contributes billing expertise to training and process improvements. Vital Care describes itself as a U.S.-based pharmacy franchise business with more than 100 franchised infusion pharmacies and clinics in 35 states.

Requirements

Two to five 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, understanding, and writing, and the ability to influence patients, caregivers, payer representatives, and others.
Demonstrated understanding of billing and collection processes, systems, and techniques for all payer types.
Ability to identify documentation gaps and problems, determine lasting solutions, make effective decisions, and take corrective action.
Strong organizational skills and ability to maintain clear, complete records of activities, cases, and supporting documentation.
Knowledge of and skill in using Microsoft Office software and pharmacy applications.
Ability to perform duties from 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.
Authorization to work in the United States and perform the work from within the United States.

Nice To Haves

Previous experience working remotely.
Detail-oriented approach and post-billing and post-payment investigative experience.

Responsibilities

Review claims with outstanding balances and identify actions to collect revenue successfully.
Follow up with insurers and patients to collect outstanding balances while building customer and business relationships.
Use payer portals to check claim dispositions.
Review explanations of benefits, remittance advices, and other documents showing claim acceptance or denial.
Identify denial reasons, take corrective action, and manage claims through timely, successful collection.
Analyze denials and trends, and recommend improvements to reduce DSO and bad debt, improve collections, and simplify payer-responsive processes.
Identify payer requirements for appeals of denied claims.
Verify insurance information with patients, order medical records, review original claim coding, compile supporting documentation, and submit appeals according to payer requirements and company processes.
Communicate collection status with franchise partners and other Vital Care departments.
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 found during collections to help prevent recurrence.
Explain patients’ financial obligations so they understand therapy costs before services begin.
Contribute medical billing expertise to training and knowledge-transfer programs, materials, policies, and procedures for the RCM team.
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.
Employee-paid voluntary life, accident, critical illness, and short-term disability insurance.
401(k) matching.
Tuition reimbursement.
Employee assistance programs for mental health, financial, and legal support.
Medical-carrier rewards programs.
Professional development and growth opportunities.
Employee referral program.