Collections Specialist - RCM

Vital Care Infusion Services•Houston, TX

1d•$19 - $23•Remote

About The Position

The Collections Specialist performs revenue cycle collection duties for Home Infusion claims, focusing on accuracy, timeliness, and adherence to established processes to reduce denial rates, days sales outstanding (DSO), and bad debt. The role identifies additional revenue opportunities and works to improve collection rates while operating within standard or accepted practice limits. This position is full-time and 100% remote.

Requirements

Two to five 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 and advance reimbursement and collection efforts.
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 Microsoft Office software 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 in a remote work environment.
Detail-oriented with post-billing and post-payment investigative experience.

Responsibilities

Review claims with outstanding balances, identify actions to collect revenue, and follow up with insurers and patients while building enduring customer and business relationships.
Use payer portals to review claim disposition.
Review explanations of benefits, remittance advices, and other documents showing claim denials or acceptance; identify denial reasons, take corrective action, and manage claims through timely collection.
Analyze denial trends and recommend process improvements to reduce DSO and bad debt, improve collection rates, and simplify payer-responsive processes.
Identify payer appeal requirements, verify insurance information with patients, order medical records, review original claim coding, compile supporting documentation, and submit appeals in accordance with 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 and therapy costs before service begins.
Contribute medical billing expertise to training and knowledge-transfer programs, materials, policies, and procedures to improve RCM team effectiveness.
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.
Employee-paid 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.