Healthcare Collections Specialist - RCM - Remote

Healthcare Collections Specialist – Insurance Follow-Up

Location:

Fully Remote

Schedule:

Monday–Friday, standard business hours. Exact start and end times depend on your time zone and team coverage needs.

Pay:

$24–$34 per hour

Department:

Revenue Cycle Management

About The Position

Use your medical billing and collections expertise to resolve insurance claims and support accurate, timely reimbursement. As a Healthcare Collections Specialist, you’ll investigate denied and underpaid claims, manage payer follow-up, and prepare reconsiderations and appeals for Medicare, Medicaid, and commercial insurance plans. This role is a strong fit for someone who enjoys researching payment issues, working independently, and collaborating with colleagues to prevent recurring denials.

Key Responsibilities

• Resolve outstanding claims: Follow up with insurance companies through payer portals and phone calls to determine claim status and secure appropriate reimbursement.
• Manage denials and underpayments: Research payment discrepancies, identify root causes, and take corrective action.
• Prepare reconsiderations and appeals: Submit supporting documentation and follow through according to payer requirements and deadlines.
• Review claim accuracy: Interpret explanations of benefits (EOBs), denial codes, and billing information to determine the appropriate next steps.
• Address recurring issues: Partner with revenue cycle colleagues to correct billing, benefits, or authorization errors and identify denial trends.
• Maintain accurate records: Document follow-up activity, respond to payer correspondence, and keep accounts updated.
• Support team performance: Meet established productivity and quality standards while managing assigned accounts.

Required Qualifications

• Previous experience in medical billing and insurance collections, including professional billing.
• Experience resolving denied and underpaid claims through reconsiderations and appeals.
• Knowledge of Medicare, Medicaid, and commercial insurance requirements.
• Working knowledge of CPT, HCPCS, and ICD-10 coding.
• Ability to interpret EOBs and insurance denial reason codes.
• Strong research, problem-solving, and written and verbal communication skills.
• Ability to prioritize accounts, manage deadlines, and work independently in a remote setting.
• A collaborative approach and willingness to learn and apply feedback.

Preferred Qualification

• Experience with infusion billing or insurance collections.