Sr Credit & Collections Specialist

Elevance Health • Plano, TX

7d • Remote

About The Position

The Sr Credit and Collections Specialist is responsible for the timely follow up and resolution of outstanding insurance claims to ensure maximum reimbursement and minimized aging accounts receivable. This role works directly with payers, internal billing teams, and operational departments to resolve claim denials, underpayments, and unpaid balances while maintaining compliance with payer and regulatory guidelines. This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. CarelonRx is a proud member of the Elevance Health family of companies. CarelonRx pairs a strong, clinical-first lens with deep pharmacy expertise to create solutions that improve outcomes, control costs, and enhance each member’s health.

Requirements

• Requires a H.S. diploma or equivalent and a minimum of 2 years of commercial debt collection experience; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

• Preferred specialty Pharmacy and/or home Infusion experience.
• Medicare and commercial insurance knowledge highly recommended.
• Strong understanding of denial management and reimbursement processes with experience in claim submissions, corrected claims and payer follow up desired.

Responsibilities

• Follows established guidelines, contacts group for the purpose of collecting past due insurance premiums and/or past due health insurance claims.
• Researches validity of past due and/or disputed debt.
• Generates demand letters.
• Prepares reports reflecting status of credit and collection activities for management review.

Benefits

• merit increases
• paid holidays
• Paid Time Off
• incentive bonus programs
• medical
• dental
• vision
• short and long term disability benefits
• 401(k) +match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources

What This Job Offers

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