Collections Specialist - RCM

Vital Care Infusion Services•Tucson, AZ

8h•Remote

About The Position

The Collections Specialist performs revenue cycle management (RCM) collection duties for Home Infusion claims, with a focus on accuracy, timeliness, and following processes that reduce denials, days sales outstanding (DSO), and bad debt. The role identifies additional revenue opportunities and works to improve collection rates while operating within standard or accepted practice limits. This position is full-time and 100% remote, with work performed from within the United States.

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, understanding, and writing, with the ability to communicate with patients, caregivers, payer representatives, and others.
Understanding of processes, systems, and techniques for successful billing and collections across payer types.
Ability to identify gaps and problems through documentation review, determine lasting solutions, make effective decisions, and take corrective action.
Strong organization skills and ability to maintain clear, complete records of activities, cases, and related documentation.
Knowledge and skill in 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.
Must be authorized to work in the United States and perform the work from within the United States.

Nice To Haves

Previous experience working remotely.
Attention to detail and post-billing and post-payment investigative experience.

Responsibilities

Review claims with outstanding balances and identify actions needed to collect revenue successfully.
Follow up with insurers and patients to collect outstanding balances while building enduring customer and business relationships.
Use payer portals to check claim disposition.
Review explanations of benefits, remittance advices, and other documents showing claim denials or acceptance.
Identify denial reasons, take corrective action, and manage claims through timely, successful collection.
Analyze denials, identify trends, and recommend process improvements to reduce DSO and bad debt, improve collection rates, and simplify processes in response to payer requirements.
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 company departments, and resolve payer issues or concerns promptly.
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 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

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 for mental health, financial, and legal support.
Medical carrier rewards programs.
Professional development and growth opportunities.
Employee referral program.