Revenue Cycle Management - Collections Specialist

Vital Care Infusion Services•Monroeville, PA

8h•$19 - $23•Remote

About The Position

Perform collection duties for Home Infusion claims, emphasizing accuracy, timeliness, and adherence to established processes to reduce denials, days sales outstanding (DSO), and bad debt. Identify additional revenue opportunities and improve collection rates while working within standard or accepted practices. This is a full-time, 100% remote position.

Requirements

Excellent English communication skills, including listening, speaking, comprehension, and writing, with the ability to influence patients, caregivers, payer representatives, and others while advancing reimbursement and collection efforts.
Demonstrated 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 supporting documentation.
Knowledge and skill in using Microsoft Office software and pharmacy applications.
Ability to perform job duties from 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.
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.

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 determine actions to collect revenue; follow up with insurers and patients and use payer portals to check claim disposition.
Review explanations of benefits, remittance advices, and other claim documents; identify denial reasons, take corrective action, and manage claims through successful collection.
Analyze denials, identify trends, and recommend process improvements to reduce DSO and bad debt, improve collection rates, and simplify payer-responsive processes.
Identify payer appeal requirements; verify patient insurance information, order medical records, review 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 account activity, communications, correspondence, and follow-up schedules in the computer system accurately and completely.
Investigate and verify benefits for pharmacy and medical third-party claims.
Report 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 the development of 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.