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.