Collections Specialist - Revenue Cycle Management

Vital Care Infusion Services•Dallas, TX

2d•Remote

About The Position

Vital Care is a U.S.-based pharmacy franchise business with more than 100 franchised infusion pharmacies and clinics in 35 states. The Collections Specialist performs Home Infusion claim collections, emphasizing accuracy, timely follow-up, and adherence to processes that reduce denials, days sales outstanding (DSO), and bad debt. The role also identifies additional revenue opportunities and works to improve collection rates while performing revenue cycle collection duties within standard or accepted practice limits. This position is fully remote and full-time. The specialist reviews claims with outstanding balances, follows up with insurers and patients, investigates billing and denial issues, and pursues claims through successful collection. The position works with payer portals and claim documentation, verifies benefits and insurance information, prepares and submits appeals, documents account activity, communicates with franchise partners and internal departments, and contributes medical billing expertise to training and process improvement. The salary range is $18.92–$23.46 per hour.

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, to answer questions and advance reimbursement and collection efforts with patients, caregivers, payer representatives, and others.
Demonstrated 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 related documentation.
Knowledge and skill using Microsoft Office software and pharmacy applications.
Ability to perform job duties from a designated workspace outside the dedicated revenue cycle management 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 approach and post-billing and post-payment investigative experience.

Responsibilities

Review claims with outstanding balances and identify actions to collect revenue.
Follow up with insurers and patients to collect outstanding balances while building customer and business relationships.
Use internet-based payer portals to determine claim disposition.
Review Explanations of Benefits, Remittance Advices, and other claim acceptance or denial documents.
Identify denial reasons, take corrective action, and manage claims through timely, successful collection.
Analyze denial trends and recommend process improvements to reduce DSO and bad debt, improve collection rates, and simplify payer-responsive processes.
Identify payer requirements for appeals of denied claims.
Verify patient insurance information, 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.
Resolve payer issues and concerns in a timely manner.
Document case activity, communications, correspondence, and account actions accurately in the computer system.
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 and therapy costs before services begin.
Contribute medical billing expertise to training and knowledge-transfer programs, materials, policies, and procedures for the revenue cycle management 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 accounts 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.
Rewards programs offered by the medical carrier.
Professional development and growth opportunities.
Employee referral program.