Collections Specialist - Revenue Cycle Management

Vital Care Infusion Services•Philadelphia, PA

2d•Remote

About The Position

Vital Care is seeking a Collections Specialist to collect Home Infusion claims with a focus on accuracy, timeliness, and adherence to processes that reduce denial rates, days sales outstanding (DSO), and bad debt. The role identifies additional revenue opportunities and improves collection rates while performing revenue cycle collection duties within standard or accepted practice limits. This is a full-time, 100% remote position. The salary range is $18.92–$23.46 per hour. The Collections Specialist reviews claims with outstanding balances, follows up with insurers and patients, and uses payer portals and billing documents to determine claim status. The role investigates denials, takes corrective action, prepares and submits appeals, documents account activity, schedules follow-ups, and communicates with patients, franchise partners, payers, and internal departments. It also identifies billing issues and process improvement opportunities, verifies benefits and financial obligations, and contributes medical billing expertise to training and knowledge-transfer materials.

Requirements

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.
Proven 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 in using the MS Office suite and pharmacy applications.
Ability to complete 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.
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.

Nice To Haves

Previous experience working remotely.
Detail-oriented, with 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 balances while building customer and business relationships.
Use payer portals to review claim disposition.
Review EOBs, RAs, and other documents indicating denials or claim acceptance.
Identify denial reasons, take corrective action, and manage claims through successful collection.
Analyze denial trends and recommend process improvements to reduce DSO and bad debt, improve collection rates, and simplify processes.
Identify payer appeal requirements; verify 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 promptly.
Document case activity, communications, and correspondence accurately in the computer system, and 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 so they understand therapy costs before service begins.
Contribute medical billing expertise to training and 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.