Collections Specialist, Aged Insurance Claims

Allegiance Mobile Health•Austin, TX

1d•Remote

About The Position

The Collections Specialist follows up on and resolves aged ground ambulance insurance claims, generally 90 days or older, across Medicare, Medicaid, Medicare Advantage, commercial, and third-party liability payers. The role supports the Revenue Cycle department by investigating unpaid claims, contacting payers to secure payment, pursuing appeals and underpayment recovery, and escalating complex accounts to protect revenue and meet timely filing limits. This is a fully remote position requiring independent work, effective time management, and HIPAA-compliant handling of protected health information. The specialist works assigned aged accounts, researches denials and payment issues, submits corrected claims and appeals, monitors deadlines, and documents account activity. The role also communicates with patients, facilities, payers, crews, and internal teams, and uses remote collaboration tools to stay connected with billing colleagues and management.

Requirements

High school diploma required.
At least three years of experience in insurance follow-up, collections, or accounts receivable management.
Demonstrated experience working aged claims and filing appeals with Medicare, Medicaid, or commercial payers.
Strong working knowledge of Medicare, Medicaid, Medicare Advantage, and commercial payer claims processing, appeal rights and timelines, and timely filing requirements.
Working knowledge of ground ambulance billing, including HCPCS service and mileage codes, modifiers, medical necessity, and documentation requirements.
Knowledge of claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs), and ability to determine appropriate resolution paths for denials.
Knowledge of coordination of benefits, third-party liability, and applicable state balance billing protections for ambulance services.
Ability to analyze aging reports and prioritize accounts by recovery potential.
Proficiency with computers, office equipment, standard billing or practice management software, and remote work technology such as VPN, video conferencing, secure messaging, and cloud-based document sharing.
Strong written and verbal communication and negotiation skills, including professional phone and video etiquette.
Ability to work independently, manage a large account inventory, and remain self-motivated and productive without in-person supervision.
Basic awareness of cybersecurity best practices and data privacy requirements for handling PHI outside a traditional office.
Maintain a private workspace that protects confidential information and prevents unauthorized access to PHI.
Have reliable internet service sufficient for company systems, billing applications, and video conferencing.
Use company-approved equipment security measures, including VPN, multi-factor authentication, and secure storage and transmission of billing data.
Meet designated work schedules, performance expectations, and communication requirements, including scheduled virtual meetings.

Nice To Haves

Associate degree.
Ground ambulance or EMS billing experience.
Professional certifications such as CRCR, CPB, or Certified Ambulance Coder (CAC).
Previous success working in a remote or telecommute position.
Intermediate Excel skills.

Responsibilities

Work assigned aged accounts receivable by aging bucket, payer, and dollar value to reduce days in A/R and meet monthly collection targets.
Contact payers by phone, payer portal, and secure messaging to obtain claim status, confirm receipt, identify nonpayment reasons, and secure payment or a resolution date.
Review denials, partial payments, and unprocessed claims; identify root causes and take corrective action.
Prepare and submit corrected claims, reconsiderations, and formal appeals with supporting documentation, and track appeals through resolution.
Monitor timely filing, appeal, and payer-specific deadlines and prioritize work to prevent avoidable write-offs.
Identify and dispute underpaid claims by comparing payments with contracted rates, fee schedules, and payer policies; follow up until corrected payment is received.
Investigate missing or incorrect insurance, coordination of benefits issues, and third-party liability; obtain updated coverage and rebill as appropriate.
Coordinate with crews, facilities, and internal departments to obtain documentation, signatures, and records needed to support payment.
Accurately document payer contacts, reference numbers, promised payment dates, and follow-up actions in the billing system, and follow up on promises to pay.
Recommend adjustments, write-offs, and collection-agency referrals according to company policy and submit them to management for approval.
Escalate payer trends, unresolved disputes, and high-dollar accounts to the Manager; track and analyze denial and aging patterns to identify recurring issues and improvement opportunities.
Respond to patient and facility inquiries about insurance balances through phone, email, secure messaging, and patient portal correspondence.
Follow HIPAA requirements and company privacy and security policies when handling PHI, including maintaining a secure remote work environment and using company-approved systems.
Use remote collaboration tools to stay connected with the billing team and management, and communicate connectivity or equipment issues that may affect productivity.
Perform other related duties and responsibilities as assigned.