Pharmacy Infusion Collections Specialist (RCM)

GeBBS Healthcare Solutions, Inc.; United States; Teletrabalho; USD 40 000 - 65 000; Tempo integral

Resumo da oferta

GeBBS Healthcare Solutions, Inc. is seeking a Collections Specialist to support Coral Connect’s pharmacy and infusion revenue cycle operations.

The role focuses on resolving outstanding insurance accounts, recovering reimbursement, and moving unpaid claims to resolution. The ideal candidate has practical collections experience, can use Caretend to investigate balances, review claim history, document follow-up, and identify next steps to secure payment.

Qualificações

• Must have completed high school or equivalent.
• Healthcare insurance collections experience required (at least 2 years).
• Hands-on Caretend experience supporting billing, reimbursement, or collections workflows.

Responsabilidades

• Own an assigned accounts receivable portfolio and follow unpaid pharmacy and infusion claims through resolution.
• Investigate payment delays through payer portals and direct contact with insurance representatives.
• Use Caretend to research account activity, track outstanding issues, and maintain clear follow-up notes.
• Evaluate denials and partial payments, determine the cause, and coordinate the appropriate correction or escalation.
• Prepare reconsiderations and appeals with supporting records within payer deadlines.
• Interpret remittance information and distinguish between contractual adjustments, unresolved insurance balances, and patient responsibility.
• Prioritize work according to account age, balance, filing deadlines, and recovery opportunity.
• Partner with billing, intake, authorization, and clinical staff to obtain information needed for payment.
• Flag recurring reimbursement problems and communicate patterns to leadership.
• Handle patient balance questions when assigned, following approved procedures and escalation guidelines.
• Meet established productivity and quality expectations while protecting confidential information.

Conhecimentos

Strong communication

Organization

Problem-solving

Caretend proficiency

Excel literacy

Formação académica

High school diploma or equivalent

Ferramentas

Caretend

Excel

Descrição da oferta de emprego

GeBBS Healthcare Solutions, Inc. is seeking a Collections Specialist to support Coral Connect’s pharmacy and infusion revenue cycle operations.

The role focuses on resolving outstanding insurance accounts, recovering reimbursement, and moving unpaid claims to resolution. The ideal candidate has practical collections experience, can use Caretend to investigate balances, review claim history, document follow-up, and identify next steps to secure payment.