Medical Collections Specialist

Accountabilities:

• Follow up on submitted insurance claims to support accurate and timely reimbursement.

• Manage assigned payer accounts and work outstanding balances through to resolution.

• Investigate denied, underpaid, and unpaid claims, identifying causes and determining appropriate corrective actions.

• Communicate directly with insurance payers to resolve claim discrepancies, address outstanding issues, and secure reimbursement.

• Review claims to determine whether they were billed correctly or require correction, reconsideration, appeal, or rebilling.

• Interpret payer contracts, coverage requirements, and reimbursement methodologies to guide collection activities.

• Collaborate with billing, pharmacy, and operations teams to resolve complex reimbursement issues and improve collections workflows.

• Respond promptly and professionally to internal and external inquiries regarding claim status and collection activity.

• Maintain accurate, complete documentation of payer communications, follow-ups, and account resolutions.

• Stay informed about medical billing regulations, coding guidelines, payer policies, and reimbursement changes.

• Use healthcare billing systems and clearinghouses to monitor claims and support effective collections processes.

• Assist with reporting, data entry, and other revenue-cycle activities as required.

• Maintain accuracy, professionalism, accountability, and consistent follow-through across all assigned accounts.

• Participate in required compliance training and adhere to applicable legal, ethical, and organizational procedures.

Requirements:

• High school diploma or GED required.

• At least 3 years of medical collections or related revenue-cycle experience.

• Previous experience communicating with insurance payers and resolving outstanding medical claims.

• Experience providing professional customer service to internal and external stakeholders.

• Basic proficiency in Microsoft Office applications, including Word, Excel, and PowerPoint.

• Strong analytical and problem-solving abilities, with the capacity to investigate claim issues and identify effective solutions.

• Persistence and confidence when following up with insurance providers and managing outstanding balances.

• Excellent attention to detail, organizational skills, and commitment to accurate documentation.

• Strong written and verbal communication skills.

• A customer-service mindset combined with financial accountability and ownership of assigned accounts.

• Ability to prioritize competing demands, manage multiple tasks, and work effectively in a fast-paced, metrics-driven environment.

• Preferred: 5 or more years of medical collections experience.

• Preferred: Previous experience in home infusion, specialty pharmacy, or infusion therapy billing and collections.

• Preferred: Experience handling insurance denials, underpayments, appeals, and payer follow-up.

• Preferred: Familiarity with healthcare billing platforms, clearinghouses, and revenue-cycle management systems.

• Demonstrated integrity, adaptability, collaboration, and commitment to continuous improvement.

Benefits:

• Hourly pay range of $26–$28 USD.

• Fully remote position within the United States.

• Consistent Monday-to-Friday schedule, from 8:00 AM to 4:30 PM CST.

• Purpose-driven work that directly supports patient access to infusion therapy.

• Opportunity to work within a patient-first, clinician-led healthcare environment.

• Collaboration with colleagues across revenue-cycle, pharmacy, clinical, and operations teams.

• Clear role expectations and opportunities for professional growth.

• Potential eligibility for a hybrid work arrangement after six months, based on performance and business needs.