Reimbursement Specialist - Healthcare

Reimbursement Specialist - Healthcare Job Description

Collections Specialist (Chicago, IL; Malvern, PA)

Join a fast-paced revenue cycle team where you’ll take the lead in resolving complex insurance claims, driving timely reimbursements, and making a direct impact on financial performance and operational success.

Your role:

• Manage denied and rejected insurance claims by researching root causes, correcting claim issues, and following up with payers to secure timely reimbursement. Review EOBs, payment variances, aging reports, and negative balances to ensure accurate claim processing.

• Work directly with insurance payers to resolve denials, authorization issues, filing errors, and reimbursement discrepancies. Escalate recurring payer trends and recommend process improvements or solutions to leadership.

• Verify patient eligibility and benefits, including qualifying diagnoses, prior testing, and authorization requirements. Interpret insurance benefits and claim outcomes to support accurate billing and reimbursement.

• Utilize Excel, dashboards, and daily/weekly worklists to track claims activity, monitor productivity, and identify reimbursement trends. Maintain compliance with internal processes, reimbursement standards, and quality expectations.

• Support team collaboration by assisting with payer resolution efforts across accounts and ensuring timely follow-up on insurance correspondence and outstanding claims.

You're the right fit if:

• You’ve acquired 2+ years of experience in Accounts Receivable Management, Reimbursement, Collections, or Denial Management, with hands‑on experience resolving denied and rejected insurance claims and working directly with payers.

• Your skills include:

  • Strong denial management and claims troubleshooting abilities

  • Knowledge of insurance payers, including Medicare, Medicaid, Blue Cross Blue Shield and commercial plans.

  • Proficiency in Excel, dashboards, and analyzing payer trends/worklists

  • Ability to verify insurance benefits and interpret EOBs (Explanation of Benefits)

  • Strong computer skills with the ability to navigate multiple systems efficiently

• You have a bachelor’s degree, High School Diploma or GED, or vocational training in finance, accounting, business administration, economics, or a related field.

• You must be able to successfully perform the following minimum Physical, Cognitive and Environmental job requirements with or without accommodation for this position.

• You’re an analytical and detail-oriented professional with strong problem-solving and communication skills, who thrives working independently in a fast-paced environment while maintaining a collaborative and adaptable team-focused mindset.

How we work together

We believe that we are better together than apart. For our office-based teams, this means working in-person at least 3 days per week. Onsite roles require full-time presence in the company’s facilities. Field roles are most effectively done outside of the company’s main facilities, generally at the customers’ or suppliers’ locations.

This is an office role.

About Philips

We are a health technology company. We built our entire company around the belief that every human matters, and we won't stop until everybody everywhere has access to the quality healthcare that we all deserve. Do the work of your life to help improve the lives of others.

• Learn more about our business.

• Discover our rich and exciting history.

• Learn more about our purpose.

• Learn more about our culture.

Philips Transparency Details

The pay range for this position in Chicago, IL and Malvern, PA is $26.00 to $41.00.

The actual base pay offered may vary within the posted ranges including job-related knowledge/skills, experience, business needs, geographical location, and internal equity.

In addition, other…