Experienced Medical Insurance Collection Specialist

Hirebridge LLC; United States; Remote; USD 60,000 - 80,000; Full time

Benefits offered by this job

Medical, Dental, Vision insurance

Company-Paid Life Insurance

Long-Term Disability

Generous PTO

401(k) with employer match

Collaborative team environment

Job summary

AIS Healthcare is seeking an experienced Revenue Cycle Collections Specialist to join our remote Financial Services team. You will manage denial management, appeals, and reimbursement follow-up for Targeted Drug Delivery services, ensuring compliant, timely payment from insurance carriers.

The ideal candidate has 3–5 years in healthcare billing and insurance collections, strong knowledge of reimbursement processes, and excellent communication skills to resolve complex issues while working

Qualifications

• 3–5 years healthcare industry experience
• 3–5 years medical billing and insurance collections experience
• Strong understanding of healthcare reimbursement and collection processes
• Knowledge of insurance plans, medical terminology, billing procedures, and healthcare regulations
• Experience with denial management and appeals
• Ability to analyze and resolve complex reimbursement issues
• Excellent verbal and written communication skills
• Strong attention to detail and organizational skills
• Ability to work independently in a remote environment
• Proficiency in Microsoft Outlook, Word, and Excel

Responsibilities

• Follow up on submitted claims to ensure prompt and accurate reimbursement
• Investigate and resolve denied, underpaid, unpaid, duplicate, and overpaid claims
• Analyze payments and denials for accuracy and proper application
• Research and resolve payment discrepancies
• Initiate and manage appeals to maximize reimbursement opportunities
• Process account adjustments, write-offs, and refund requests in accordance with company policies
• Collaborate with internal departments to obtain information required for payment resolution
• Maintain detailed documentation of all collection activity and payer communications
• Resolve denial issues within established turnaround times
• Ensure compliance with HIPAA, federal regulations, payer requirements, and company policies
• Identify opportunities to improve reimbursement and reduce outstanding accounts receivable
• Maintain knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes
• Develop a working knowledge of NDC numbers, metric quantities, and infusion supplies
• Support team members by sharing knowledge and best practices

Job description

Experienced Medical Insurance Collection Specialist

Please Apply Only If You Have 3–5 Years of Medical Insurance Collections Experience

AIS Healthcare is the leading provider of Targeted Drug Delivery (TDD) and Infusion Care solutions. Guided by our core values of Innovation, Stewardship, and Unity, we are committed to Advancing Quality and Improving Lives for the patients, providers, and communities we serve.

We are seeking an experienced Revenue Cycle Collections Specialist to join our Financial Services team. This role is ideal for a healthcare collections professional who enjoys solving complex reimbursement issues, managing denials and appeals, analyzing contracts, and maximizing claim reimbursement.

If you're looking for a remote opportunity with a company that values collaboration, accountability, and professional growth, we'd love to hear from you.

Why Join AIS Healthcare?

• We offer a comprehensive benefits package, including:
• Medical, Dental, and Vision Insurance
• Company-Paid Life Insurance
• Long-Term Disability Insurance
• Generous Paid Time Off
• 401(k) with Generous Employer Match
• Supportive and Collaborative Team Environment

Position Summary

The Revenue Cycle Collections Specialist is responsible for managing collection activities related to Targeted Drug Delivery (TDD) services. This includes reimbursement follow-up, denial management, appeals, contract analysis, payment investigation, and resolving billing-related issues with insurance carriers and other responsible parties.

The ideal candidate will possess strong healthcare collections experience, a thorough understanding of insurance reimbursement processes, and the ability to independently resolve complex account issues while maintaining compliance with federal, state, and payer requirements.

What You'll Do

• Follow up on submitted claims to ensure prompt and accurate reimbursement
• Investigate and resolve denied, underpaid, unpaid, duplicate, and overpaid claims
• Analyze payments and denials for accuracy and proper application
• Research and resolve payment discrepancies
• Initiate and manage appeals to maximize reimbursement opportunities
• Process account adjustments, write-offs, and refund requests in accordance with company policies
• Collaborate with internal departments to obtain information required for payment resolution
• Maintain detailed documentation of all collection activity and payer communications
• Resolve denial issues within established turnaround times
• Ensure compliance with HIPAA, federal regulations, payer requirements, and company policies
• Identify opportunities to improve reimbursement and reduce outstanding accounts receivable
• Maintain knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes
• Develop a working knowledge of NDC numbers, metric quantities, and infusion supplies
• Support team members by sharing knowledge and best practices

Required Qualifications

• High School Diploma or GED
• 3–5 years of healthcare industry experience
• 3–5 years of medical billing and insurance collections experience
• Strong understanding of healthcare reimbursement and collection processes
• Knowledge of insurance plans, medical terminology, billing procedures, and healthcare regulations
• Experience with denial management and appeals
• Ability to analyze and resolve complex reimbursement issues
• Excellent verbal and written communication skills
• Strong attention to detail and organizational skills
• Ability to work independently in a remote environment
• Proficiency in Microsoft Outlook, Word, and Excel

Preferred Qualifications

• Intrathecal Pain Management experience
• Specialty Pharmacy experience
• Experience working with infusion therapies and reimbursement models
• Knowledge of NDC numbers and infusion-related supplies
• Understanding of payer contracts and reimbursement methodologies

About AIS Healthcare

AIS Healthcare is the nation's leading provider of advanced sterile, patient‑specific intrathecal pump medications and in‑home infusion therapies. Through innovative pharmacy services, specialized nursing support, and comprehensive care coordination, we help providers deliver exceptional patient care and outcomes.

We’re looking for positive, hardworking professionals who are passionate about making a difference in the lives of patients and providers.

AIS Healthcare | Advancing Quality. Improving Lives.