Pharmacy Accounts Receivable Collections Specialist

McKesson•Cary, NC

13d•Hybrid

About The Position

As a Senior Associate AR Collections Specialist at Biologics by McKesson, you will manage insurance and patient accounts receivable accurately and efficiently to support a healthy revenue cycle, reduce financial risk, and collaborate with patients, payers, and internal partners. This hybrid role is based in Cary, North Carolina, with one day per week in the office. The target rate is $26–$27 per hour; the stated base pay range is $20.72–$34.54 per hour. The role typically requires five or more years of related experience. An associate degree in healthcare administration, business, or a related field is preferred. Relevant certification or training in medical billing, insurance collections, payer policies, or reimbursement processes may also be considered.

Requirements

Typically five or more years of related experience.
At least two years of current experience handling high-volume insurance and patient collections in a specialty pharmacy, medical or infusion office, or another relevant healthcare services setting.
Strong knowledge of pharmacy or medical collections, denial processing, appeal submission, and insurance EOB review.
Strong prioritization and time-management skills.
Ability to manage complex issues independently, adapt to changing priorities, and collaborate with remote internal and external teams.
Strong analytical and problem-solving skills, particularly in identifying and resolving insurance reimbursement issues.
Strong proficiency in Microsoft Office, Excel, and PowerPoint.
Clear written and verbal communication skills, including the ability to work effectively with third-party payers, insurance companies, and internal business units.
Strong collaboration and influence skills, with the ability to build cross-functional relationships and contribute in a team-oriented environment.

Nice To Haves

Associate degree in healthcare administration, business, or a related field is preferred.
Relevant certification or training in medical billing, insurance collections, payer policies, or reimbursement processes may be considered.
Familiarity with oncology therapies and reimbursement is a plus.
Experience with commercial and governmental insurance payer and clearinghouse portals.
Advanced knowledge of Medicare, Medicaid, and commercial insurance billing and reimbursement policies.
Knowledge of health insurance coverage and reimbursement, including NDC and HCPCS coding and billing practices.
Ability to research accounts, interpret EOBs and remittance advice, and resolve high-dollar claims efficiently.

Responsibilities

Prioritize and manage a high-volume workload based on claim age, complexity, and urgency.
Own the accounts receivable process for assigned accounts, using reports, analytics, and account reviews to support revenue-cycle performance metrics.
Analyze complex insurance and patient accounts outstanding more than 31 days, follow up in accordance with payer policy, and use effective collection strategies to accelerate resolution.
Investigate denials, overpayments, underpayments, and rejections; identify root causes; recommend solutions; prepare appeals; and coordinate timely claim resubmissions.
Process approved account adjustments and issue overpayment refunds promptly.
Respond clearly, professionally, and sensitively to patient balance, account, and claim inquiries, and work with payers and internal teams to resolve issues within timely-filing and organizational requirements.
Work 50–70 accounts per workday and accurately document collection activity, claim status, and account disposition according to quality and productivity standards.
Maintain current knowledge of third-party payer and CMS reimbursement requirements and follow applicable policies, procedures, and guidelines.
Participate in billing and collections meetings, contribute to account resolution, and support continuous improvement.
Perform other duties as assigned by the supervisor or manager.