Remote Reimbursement & Claims Specialist - Dialysis

Innovative Renal Care; Franklin (TN); Remote; USD 60,000 - 90,000; Full time

Benefits offered by this job

401(k) match

Healthcare coverage

Remote work

Job summary

Innovative Renal Care is seeking a Reimbursement & Collections Specialist to manage post-adjudication claim balances for a group of dialysis facilities, focusing on unpaid or underpaid claims, payer follow-up, and balance resolution.

This 100% remote position requires knowledge of Medicare, VA, TRICARE, and other government payers, plus strong communication and problem-solving skills to coordinate with patients and internal teams while ensuring timely payments.

Qualifications

• Bachelor's degree in business/healthcare management preferred.
• 4-5 years in medical claims collections, payer follow-up, or healthcare reimbursement.
• Experience in dialysis, nephrology, or ESRD claims preferred.
• Strong knowledge of Medicare, VA, TRICARE, and other government payer processes.
• Proficiency in Microsoft Office and healthcare billing platforms.
• Excellent communication, problem-solving, and customer service skills.
• Ability to work independently in a remote environment with high accuracy and attention to detail.

Responsibilities

• Manage and collect postadjudication claim balances for assigned dialysis facilities.
• Conduct claim followup with Medicare, VA, TRICARE, Medicaid, and commercial payers.
• Review EOBs and remittance advice to determine next steps for balances.
• Prepare and submit appeals, reconsiderations, adjustments, and corrections.
• Resolve payer correspondence and address issues identified via mail, reports, and system alerts.
• Allocate coinsurance, deductibles, and patient responsibility accurately in the database.
• Communicate with patients and collaborate with internal departments to resolve balances.

Skills

Medical claims collections

Payer follow-up

Healthcare reimbursement

Microsoft Office

Education

Bachelor's degree in business or healthcare management

Tools

Healthcare billing platforms

Job description

Innovative Renal Care is seeking a Reimbursement & Collections Specialist to manage post-adjudication claim balances for a group of dialysis facilities, focusing on unpaid or underpaid claims, payer follow-up, and balance resolution.

This 100% remote position requires knowledge of Medicare, VA, TRICARE, and other government payers, plus strong communication and problem-solving skills to coordinate with patients and internal teams while ensuring timely payments.