Collections Specialist
RemoteUnited States
Job Summary
Manage assigned accounts receivable for pharmacy and AIC infusion services by working denied, rejected, and underpaid claims to ensure maximum reimbursement. Contact insurance payers to resolve claim issues, verify status, and secure payment while reviewing EOBs and ERAs to identify discrepancies. Investigate billing errors, coding issues, and authorization-related denials, then submit appeals and supporting documentation as needed. Monitor aging reports, prioritize accounts based on timely filing limits, and collaborate with billing, coding, intake, and clinical teams to resolve claim issues. Maintain accurate documentation, ensure compliance with HIPAA and company policies, and assist with patient account inquiries. Support month-end reporting and AR reconciliation activities.
Required Qualifications
- High school diploma or equivalent
- 1-2 years of experience in medical collections
- Knowledge of infusion billing, specialty drug reimbursement, and HCPCS/J-codes
- Strong understanding of payer guidelines, appeals processes, and denial management
- Experience with EHR/Practice Management systems (e.g., WeInfuse, CareTend, Brightree, or similar)
- Proficiency in Microsoft Excel and reporting tools
- Strong analytical and problem-solving skills
- Excellent communication and negotiation abilities
- Attention to detail and accuracy
- Ability to manage a high-volume workload and meet deadlines
- Critical thinking and persistence in resolving complex claims
- Team-oriented with the ability to work independently
- Bachelor's degree or relevant experience
Desired Qualifications
- specialty pharmacy or infusion services
- Education: Bachelor's degree
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