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.