Revenue Cycle Management - Collections Specialist

Vital Care Infusion Services • Phoenix, AZ

6d • Remote

About The Position

Vital Care is seeking a Collections Specialist to join their Revenue Cycle Management team. This role focuses on collecting Home Infusion claims with accuracy and timeliness to reduce denial rates, DSO, and bad debt. The specialist will identify revenue opportunities and improve collection rates, performing duties within standard practice limits. This position is 100% remote.

Requirements

• 2-5 years home infusion billing and/or collections experience required.
• High School Diploma and additional specialized training in intake, pharmacy/medical billing, and/or collections.
• Excellent communication skills (listening, speaking, understanding, writing English).
• Proven understanding of processes, systems, and techniques for successful billing and collection with all payer types.
• Proven ability to identify gaps and problems, determine solutions, make decisions, and take corrective action.
• Strong organization skills with the ability to track and maintain clear, complete records.
• Proven knowledge and skill in the utilization of MS Office suite of software and pharmacy applications.
• Ability to complete job duties in a designated workspace outside the dedicated RCM location.
• Disciplined work ethic with ability to work remotely with minimum direct supervision to meet production and collection targets.

Nice To Haves

• Previous remote work environment is a plus.
• Detailed oriented with post-billing and post-payment investigative experience preferred.

Responsibilities

• Review claims with outstanding balances and identify actions for collection.
• Follow up with insurers and patients to collect outstanding balances.
• Utilize Payer Portals for claim disposition.
• Review EOBs, RAs, and other documents indicating denials or claims acceptance.
• Identify reasons for denials, take corrective action, and ensure timely collection.
• Analyze denials, identify trends, and recommend process improvements.
• Identify payor requirements for submitting appeals for denied claims.
• Verify insurance information, order medical records, review claim coding, compile documentation, and submit appeals.
• Communicate effectively with franchise partners and other VCI departments regarding collection status.
• Resolve payer issues/concerns timely.
• Document case activity, communications, and correspondence in the computer system.
• Schedule follow-ups at required intervals.
• Investigate and verify benefits for pharmacy and medical third-party claims.
• Communicate billing problems found during the collection process.
• Communicate financial obligation information with patients.
• Contribute medical billing expertise to training and knowledge transfer programs.
• Assist with processing online adjudication of collection issues and nurse billing.
• Perform other related duties as assigned.

Benefits

• Comprehensive medical, dental, and vision plans
• Flexible spending accounts
• Health savings accounts
• Paid time off
• Personal days
• Company-paid holidays
• Paid Paternal Leave
• Volunteerism Days off
• Company-sponsored basic life insurance
• Long-term disability insurance
• Employee-paid voluntary life insurance
• Employee-paid accident insurance
• Employee-paid critical illness insurance
• Employee-paid short-term disability insurance
• 401(k) matching
• Tuition reimbursement
• Employee assistance programs (mental health, financial, and legal)
• Rewards programs offered by medical carrier
• Professional development and growth opportunities
• Employee Referral Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED