Collections Specialist - RCM

Vital Care Infusion Services•Tucson, AZ

2h•$19 - $23•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 with a focus on accuracy, timeliness, and adherence to processes that reduce denials, days sales outstanding (DSO), and bad debt. The specialist identifies additional revenue opportunities and performs revenue cycle collection duties within standard or accepted practice limits. The position involves reviewing and following up on outstanding claims with insurers and patients, researching payer requirements, addressing denials, submitting appeals, investigating benefits, documenting account activity, and communicating with patients, franchise partners, and internal departments. It also contributes billing expertise to training and process improvements. The role requires working from a designated remote workspace with minimal direct supervision and meeting production and collection targets.

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 influence 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 related documentation.
Knowledge and skill 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.

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 collection actions, and follow up with insurers and patients to collect balances while building customer and business relationships.
Use payer portals to check claim disposition.
Review EOBs, remittance advices, and other claim documents; identify denials, take corrective action, and manage claims through timely collection.
Analyze denial trends and recommend process improvements to reduce DSO and bad debt and improve collection rates.
Identify payer appeal requirements; verify insurance information, order medical records, review claim coding, compile supporting documents, and submit appeals according to 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 account activity, communications, correspondence, and follow-up actions in the computer system, scheduling 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 and therapy costs before services begin.
Contribute billing expertise to training and knowledge-transfer programs, materials, policies, and procedures that improve RCM team efficiency and effectiveness.
Assist with online adjudication of collection issues and nurse billing as assigned.
Perform other related duties as assigned.