Remote PFS Collections Specialist: Claims & Denials

Confluent Health LLC; New York (NY); Remote; USD 40,000 - 55,000; Full time

Job summary

Confluent Health, LLC is seeking a Remote Medical Billing Collections Specialist to manage patient and payer balances according to revenue cycle policies. You will monitor accounts, follow up on claims and denials, and ensure accurate reimbursement for services provided.

A high school diploma or GED, basic Windows computer skills, and strong communication are required. The role emphasizes attention to detail, problem solving, teamwork, and the ability to handle confidential information in a

Qualifications

• High school diploma or GED required.
• Computer proficiency with Windows-based technologies.
• Ability to be discreet and protect confidential information.
• Prior medical office experience preferred.
• Excellent problem-solving and attention to detail.
• Ability to handle difficult situations with a positive attitude.
• Good interpersonal, oral and written communication.
• Strong organizational and time management skills.
• Ability to meet deadlines; work well in a team.
• Stress management in a fast-paced environment.

Responsibilities

• Monitors outstanding balances to determine next steps in the collection process.
• Follows up on claims and denials to maximize reimbursement.
• Reviews accounts receivable activities and calls on balances or claims.
• Generates insurance paperwork including claim forms and collection letters.
• Reviews EOBs to determine reimbursement accuracy.
• Sends claims for adjudication via portals.
• Investigates and appeals denied or underpaid claims.
• Responds to inquiries from patients and payors by phone or written requests.
• Tracks and resolves discrepancies.
• Follows up on unpaid claims after denial to obtain settlement.
• Audits insurance and patient accounts to identify refunds.
• Responds promptly and courteously to inquiries.
• Provides clear communication and customer service on collection issues.
• Helps patients develop payment plans.
• Identifies patterns indicating potential issues.
• Adheres to policies and supports high-quality customer service.
• Performs other duties as needed.
• Submits billing data to insurance providers.
• Participates in continuing education related to duties.

Skills

Attention to detail

Problem solving

Interpersonal skills

Time management

Teamwork

Communication

Discretion

Multitasking

Independent work

Stress management

Education

High school diploma or GED

Job description

Confluent Health, LLC is seeking a Remote Medical Billing Collections Specialist to manage patient and payer balances according to revenue cycle policies. You will monitor accounts, follow up on claims and denials, and ensure accurate reimbursement for services provided.

A high school diploma or GED, basic Windows computer skills, and strong communication are required. The role emphasizes attention to detail, problem solving, teamwork, and the ability to handle confidential information in a