Collections Specialist

Talentify

Boca Raton (FL)

Remote

USD 50,000 - 65,000

Full time

14 days+
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Benefits offered by this job

Health insurance
Dental insurance
Vision insurance
Life insurance
401k
Paid time off

Job summary

Coral Connect, LLC seeks a Collections Specialist for Pharmacy and Ambulatory Infusion Center to manage accounts receivable, pursue reimbursement, and resolve payer and patient issues across specialty pharmacy and infusion claims.

You will follow up on denials, review EOBs and ERAs, contact payers to secure payment, investigate billing errors, and support AR reconciliation. This is a remote role with limited travel.

Qualifications

  • 1-2 years in medical collections; infusion experience preferred.
  • Knowledge of infusion billing and HCPCS/J-codes preferred.
  • Proficient in Excel and reporting tools.

Responsibilities

  • Manage accounts receivable for pharmacy and AIC infusion services.
  • Work denied, rejected, and underpaid claims to maximize reimbursement.
  • Contact insurance payers to resolve claim issues and verify status.
  • Review EOBs/ERAs to identify discrepancies and resolve issues.
  • Investigate billing errors and authorization denials; submit appeals as needed.
  • Monitor aging reports and prioritize accounts based on timely filing.
  • Collaborate with billing, coding, intake, and clinical teams to resolve issues.
  • Maintain accurate documentation of collection activities and ensure HIPAA compliance.

Skills

Medical collections
Payer guidelines
Denial management
Excel
Communication

Education

Bachelor's degree

Tools

WeInfuse
CareTend
Brightree

Job description

Position: Collections Specialist - Pharmacy & AIC Infusion
Company Bio

Coral Connect, LLC ("Coral") is a technology-enabled service provider focused on reducing healthcare costs through intelligent data management, pharmacy optimization, and value-driven sourcing. Our mission is to make specialty care more accessible, efficient, and equitable by improving operations at community care organizations, infusion centers, and specialty providers.

Job Overview

The Collections Specialist for Pharmacy and Ambulatory Infusion Center (AIC) is responsible for managing outstanding accounts receivable, ensuring timely reimbursement, and resolving payer and patient account issues. This role focuses on specialty pharmacy and infusion claims, requiring a strong understanding of complex billing, payer guidelines, and reimbursement methodologies.

Responsibilities
  • Manage and follow up on assigned accounts receivable for pharmacy and AIC infusion services
  • Work denied, rejected, and underpaid claims to ensure maximum reimbursement
  • Contact insurance payers to resolve claim issues, verify claim status, and secure payment
  • Review Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs) to identify discrepancies
  • Investigate and resolve billing errors, coding issues, and authorization-related denials
  • Submit appeals and supporting documentation as needed
  • Monitor aging reports and prioritize accounts based on timely filing limits and reimbursement impact
  • Collaborate with billing, coding, intake, and clinical teams to resolve claim issues
  • Identify trends in denials or payer behavior and escalat[?] systemic issues
  • Maintain accurate documentation of all collection activities in the system
  • Ensure compliance with payer requirements, HIPAA regulations, and company policies
  • Assist with patient account inquiries, including balance questions and payment arrangements (as applicable)
  • Support month-end reporting and AR reconciliation activities
Qualifications
  • High school diploma or equivalent required
  • 1-2 years of experience in medical collections, preferably in specialty pharmacy or infusion services preferred
  • Knowledge of infusion billing, specialty drug reimbursement, and HCPCS/J-codes preferred
  • Strong understanding of payer guidelines, appeals processes, and denial management
  • Experience with EHR/Practice Management systems (e.g., WeInfuse, CareTend, Brightree, or similar)
  • Proficiency in Microsoft Excel and reporting tools
  • Strong analytical and problem-solving skills
  • Excellent communication and negotiation abilities
  • Attention to detail and accuracy
  • Ability to manage a high-volume workload and meet deadlines
  • Critical thinking and persistence in resolving complex claims
  • Team-oriented with the ability to work independently
Education

Bachelor's degree or relevant experience is preferred.

License Requirement

N/A

Job Benefits
  • Health, Dental, Vision, Life, 401k, Paid Time Off.
Location

Remote with limited travel to client locations, internal business meetings, and other locations as needed.

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