Collections Specialist - Revenue Cycle Management

Perform duties to collect Home Infusion claims, focusing on accuracy, timeliness, and adherence to processes to reduce denial rate, DSO, and bad debt. Recognize additional revenue opportunities and improve collection rates; perform revenue cycle collection duties within standard or accepted practice limits. Review claims with outstanding balances and identifies actions to successfully collect revenues. Follow up with insurers and patients to collect outstanding balances in an environment focused on building enduring customer and business relationships. Utilize payer portals via the internet for claim disposition. Review documents received including EOBs and RAs; identify reasons for denials, take corrective action, and own claims through to timely, successful collection. Analyze denials, identify trends, and recommend process improvements to reduce DSO and bad debt. Identify payor requirements for submittal of appeals for denied claims; verify insurance information with patients, order medical records, review original claim coding, and submit appeals per payor requirements and VCI processes. Communicate with franchise partners and other departments regarding the status of collections; resolve payer issues timely. Document case activity and schedule follow-ups. Investigate and verify benefits for pharmacy and medical third-party claims. Contribute medical billing expertise to training materials and procedures to improve RCM efficiency. Be prepared to work remotely with disciplined work habits and meet production and collection targets.