Collections Specialist - Revenue Cycle Management

Vital Care Infusion Services•Tucson, AZ

1d•Remote

About The Position

Vital Care is a U.S.-based pharmacy franchise business supporting locally owned infusion pharmacies and clinics. The Collections Specialist performs Home Infusion claims collection work, focusing on accuracy, timeliness, and adherence to processes that reduce denials, days sales outstanding (DSO), and bad debt. The role identifies additional revenue opportunities, improves collection rates, and performs revenue cycle collection duties within standard or accepted practice limits. This is a full-time, 100% remote position, and work must be performed from within the United States. The specialist reviews claims with outstanding balances, follows up with insurers and patients, uses payer portals, and reviews explanations of benefits, remittance advices, and other claim documents. The role investigates denials, takes corrective action, prepares and submits appeals, verifies benefits and insurance information, and documents account activity and follow-up actions. The specialist also communicates with patients, franchise partners, and internal departments; identifies billing issues and trends; and contributes medical billing expertise to RCM training and process improvement. The position requires 2–5 years of home infusion billing and/or collections experience, a high school diploma, and additional specialized training in intake, pharmacy/medical billing, and/or collections. Prior remote-work experience is preferred but not required. The salary range is $18.92–$23.46 per hour. Vital Care describes its workplace as inclusive and growth-focused and is an equal-opportunity employer.

Requirements

2–5 years of home infusion billing and/or collections experience.
High school diploma and additional specialized training in intake, pharmacy/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 and advance reimbursement and collection efforts.
Proven understanding of processes, systems, and techniques for successful billing and collection 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 the MS Office suite 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.
Physical ability to sit for prolonged periods, frequently use a keyboard, occasionally reach for files or supplies, perform precise finger and hand movements, and read documents and computer screens.

Nice To Haves

Previous experience working remotely.
Detail-oriented approach and post-billing and post-payment investigative experience.

Responsibilities

Review claims with outstanding balances and identify actions to collect revenues.
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 documents showing denials or claim 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.
Identify payer appeal requirements; verify patient insurance information, order medical records, review original claim coding, compile supporting documentation, and submit appeals.
Communicate collection status to franchise partners and other VCI departments, and resolve payer issues and concerns in a timely manner.
Document case activity, communications, correspondence, and claim-resolution actions in the computer system; schedule follow-ups at required intervals.
Investigate and verify benefits for pharmacy and medical third-party claims.
Communicate billing problems found during collection work to help prevent recurrence.
Explain patients’ financial obligations so they understand therapy costs before service begins.
Contribute medical billing expertise to the development 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.

Benefits

Comprehensive 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 covering mental health, financial, and legal support.
Rewards programs offered by the medical carrier.
Professional development and growth opportunities.
Employee referral program.