Collections Specialist - RCM

Vital Care Infusion Services•Phoenix, AZ

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 revenue cycle collection duties, focusing on accurate and timely claim resolution and adherence to processes that reduce denials, days sales outstanding (DSO), and bad debt. The role also identifies revenue opportunities and works to improve collection rates while maintaining effective relationships with patients, payers, franchise partners, and internal departments. This position is full-time and 100% remote; employees must perform their work from within the United States. The specialist reviews outstanding claims, follows up with insurers and patients, analyzes denials, and takes corrective action through successful collection. The role includes verifying benefits and insurance information, researching payer requirements, preparing and submitting appeals, documenting account activity, scheduling follow-ups, and communicating patients’ financial obligations. The specialist also contributes billing expertise to RCM training and process improvements and assists with online adjudication and nurse billing as assigned. 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 helpful but not required. 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/medical billing, and/or collections.
Excellent English communication skills, including listening, speaking, understanding, and writing, to answer questions and advance reimbursement and collection efforts.
Proven understanding of processes, systems, and techniques for successful billing and collections across payer types.
Ability to identify gaps and problems from documentation, 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 perform job 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.

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 revenue successfully.
Follow up with insurers and patients to collect outstanding balances while building customer and business relationships.
Use payer portals to determine claim disposition.
Review EOBs, remittance advices, and other documents indicating claim denials or acceptance.
Identify denial reasons, take corrective action, and manage claims through timely and successful collection.
Analyze denial trends and recommend process improvements to reduce DSO and bad debt and improve collection rates and processes.
Identify payer requirements for appealing denied claims; verify 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 departments, and resolve payer issues and concerns promptly.
Document case activity, communications, correspondence, and 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 identified during collections to help prevent recurrence.
Explain patients’ financial obligations so they understand therapy costs before starting service.
Contribute medical billing expertise to RCM 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.

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, including mental health, financial, and legal support
Medical-carrier rewards programs
Professional development and growth opportunities
Employee referral program