Collections/Appeals Specialist I - REMOTE

Lensa; Sarasota (FL); Remote; USD 35,000 - 50,000; Full time

Job summary

A leading company in healthcare services is seeking a Collections/Appeals Specialist I for a remote position. The role involves following up on insurance balances, resolving claims, and ensuring compliance with regulations. Ideal candidates should have strong communication skills and a background in medical collections. This entry-level position offers an opportunity to grow in the healthcare revenue cycle field.

Qualifications

• 0-2 years of experience in medical collections or healthcare revenue cycle operations required.
• Experience with insurance follow-up and claim resolution preferred.

Responsibilities

• Perform follow-up on outstanding insurance balances and document account activity.
• Make outbound calls to insurance payers and handle incoming correspondence.
• Ensure compliance with local, state, and federal regulations.

Skills

Medical collections processes

Payer reimbursement policies

Insurance claim resolution

Problem-solving skills

Analytical skills

Effective communication skills

Attention to detail

Education

H.S. Diploma or GED

Associate Degree in Business, Finance, Healthcare Administration

Tools

Electronic medical record (EMR) systems

Patient accounting systems

Collections software

Job description

Collections/Appeals Specialist I - REMOTE

Join to apply for the Collections/Appeals Specialist I - REMOTE role at Lensa

Collections/Appeals Specialist I - REMOTE

1 day ago Be among the first 25 applicants

Join to apply for the Collections/Appeals Specialist I - REMOTE role at Lensa

Get AI-powered advice on this job and more exclusive features.

Lensa is the leading career site for job seekers at every stage of their career. Our client, Community Health Systems, is seeking professionals. Apply via Lensa today!

Job Summary

The Collections Specialist I is responsible for performing collection follow-up on outstanding insurance balances, identifying claim issues, and ensuring timely resolution in compliance with government and managed care contract terms. This role requires effective communication with insurance payers, documentation of account activity, and adherence to applicable regulations to support revenue cycle operations.

Essential Functions

• Performs follow-up on outstanding insurance balances within the required timeframe, obtaining payment confirmation or required documentation.
• Documents all actions taken on accounts within the appropriate system, ensuring a clear and traceable resolution process.
• Makes the required number of outbound calls to insurance payers while maintaining professional and courteous communication.
• Handles and resolves incoming correspondence within five days of receipt, updating the system with relevant information.
• Analyzes assigned accounts using AS400, Meditech, Accurint, Cerner, directory assistance, and credit reports to maximize collection efforts.
• Processes inbound and outbound calls professionally, providing exceptional customer service while resolving outstanding balances.
• Ensures proper application of account dispositions and follows self-pay policies and procedures.
• Adheres to all local, state, and federal laws and regulations, including FDCPA, TCPA, FCRA, CFPB, PCI, UDAAP, and HIPAA compliance standards.
• Performs other duties as assigned.
• Complies with all policies and standards.
  
  

Qualifications

• H.S. Diploma or GED required
• Associate Degree in Business, Finance, Healthcare Administration, or a related field preferred
• 0-2 years of experience in medical collections, accounts receivable, billing, or healthcare revenue cycle operations required
• Experience working with insurance follow-up, claim resolution, and payer communication in a healthcare setting preferred
  
  

Knowledge, Skills And Abilities

• Strong understanding of medical collections processes, payer reimbursement policies, and insurance claim resolution.
• Proficiency in electronic medical record (EMR) systems, patient accounting systems, and collections software.
• Knowledge of insurance contracts, denials management, and accounts receivable workflows.
• Excellent problem-solving and analytical skills to research and resolve outstanding claims.
• Effective verbal and written communication skills to interact with insurance payers, patients, and internal teams.
• Strong attention to detail with the ability to document account activity accurately.
• Ability to work independently in a fast-paced environment while meeting productivity and quality standards.
• Knowledge of regulatory compliance, including HIPAA, FDCPA, and applicable healthcare finance laws.
  
  

Equal Employment Opportunity

This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Accounting/Auditing and Finance

• Industries

  IT Services and IT Consulting

Referrals increase your chances of interviewing at Lensa by 2x

Sign in to set job alerts for “Collections Specialist” roles.

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.