Collections Specialist - RCM

Vital Care Infusion Services•Philadelphia, PA

19h•$19 - $23•Remote

About The Position

The Collections Specialist performs revenue cycle management collection duties for Home Infusion claims, with an emphasis on accuracy, timeliness, and adherence to processes that reduce denials, days sales outstanding (DSO), and bad debt. The role identifies additional revenue opportunities and improves collection rates while working within standard or accepted practice limits. This is a full-time, 100% remote position. Work must be 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 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 documentation.
Knowledge of 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.

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, identify actions to collect revenue, and follow up with insurers and patients while building strong customer and business relationships.
Use payer portals to check claim disposition.
Review EOBs, remittance advices, and other documents; identify denial reasons, take corrective action, and manage claims through successful collection.
Analyze denials, identify trends, and recommend process improvements to reduce DSO and bad debt, improve collection rates, and simplify payer-responsive processes.
Identify payer appeal requirements; verify patient insurance information, order medical records, review claim coding, compile supporting documentation, and submit appeals in accordance with payer requirements and company processes.
Communicate collection status with franchise partners and other departments, and resolve payer issues and concerns in a timely manner.
Document case activity, communications, correspondence, and resolution actions in the computer system; schedule follow-ups at required intervals.
Investigate and verify benefits for pharmacy and medical third-party claims.
Report 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 the design of RCM 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.