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Healthcare Collections Specialist – RCM

Remote role Full-time Open position

Job Description:

  • Responsible for follow-up on outstanding claims with insurance companies through portals and phone calls.
  • Research and resolve incorrectly processed claims.
  • Determine root causes and establish trends across payors and/or sites.
  • Utilize reconsiderations and appeals to accurately fight denied or underpaid claims.
  • Understand other aspects of revenue cycle management (such as benefits, authorizations, billing) to identify any front-end errors and take steps to correct as needed.
  • Perform core tasks and claim follow-up efficiently; meet production goals, quality standards, and team goals and partner with leadership to deliver overall strong results.
  • Respond to all insurance and claim related correspondence timely.
  • Perform other duties as assigned by supervisor.

Requirements:

  • Knowledge of CPT, HCPCS, and ICD-10 coding
  • Expertise in health insurance claim denials
  • Understanding payor requirements
  • Previous medical billing and claims collection experience
  • Ability to evaluate options and to make efficient decisions
  • Strong written and verbal communication
  • Ability to read an EOB and understand denial reason codes
  • Infusion background a plus
  • Exhibit overall behavior and actions that demonstrate willingness to learn, be coached, and take accountability for self-improvement and growth; be a collaborative team player.

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