Revenue Specialist III - 258318

Medix™; Denver (CO); Hybrid; USD 70,000 - 95,000; Full time

Job summary

Medix is seeking a Specialized Collections Specialist to investigate and resolve complex, high-dollar AR across commercial patient accounts. The role focuses on root-cause analysis, COB/eligibility issues, and strategic account resolution within a hybrid Denver setting.

Join a team dedicated to maximizing cash collection and retention while navigating proprietary systems and data-driven workflows to resolve stuck accounts efficiently.

Qualifications

• Experience with insurance payers, COB and general collections.
• Strong Excel skills and ability to learn proprietary software systems.
• Ability to navigate ambiguous workflows and investigate root causes independently.
• Healthcare AR experience is a plus.

Responsibilities

• Manage high-dollar, complex AR accounts and portfolios to pursue payments.
• Proactively contact employer groups and payers to resolve billing issues (COB & eligibility).
• Analyze debits/credits to ensure correct payments and credits.
• Execute targeted account touches that drive claim resolution.
• Use data-driven workflows and Excel pivoting to pivot through data and tag opportunities.

Skills

Revenue Cycle Knowledge

Excel Proficiency

Critical Thinking

Adaptability

Resourcefulness

Tools

Excel

Nautilus

Reggie

Nova

Job description

Specialized Collections Specialist (Specialist 3)

Location: Denver, CO (Hybrid) On-site 3 days in a row/month then remote rest of the month

Team: Specialized Collections / Mainstream Team (Commercial Patients)

About the Role

Our client is seeking a Specialized Collections Specialist to investigate, root-cause, and resolve complex, high-dollar Accounts Receivable (AR) issues across their commercial patient accounts. This role is essential to maximizing cash collection and retention. You will navigate ambiguous, non-linear workflows to investigate the root causes of underlying billing issues rather than relying on a rigid, step-by-step workbook. Success in this role is driven by touch efficiency and strategic account resolution over simple activity volume.

What You Will Do

• Portfolio Management: Manage and work high-dollar, complex AR accounts and non-government credit/debit portfolios to retain or pursue payments.
• Root-Cause Investigation: Proactively contact employer groups and insurance payers to identify and resolve underlying billing issues, including Coordination of Benefits (COB) and eligibility discrepancies.
• Credit & Debit Review: Analyze debits to pursue outstanding balances and thoroughly review credits to ensure the retention of correct payments.
• Targeted Resolution: Execute targeted account touches that lead directly to claim resolution rather than basic, repetitive claim touches.
• Data-Driven Workflow: Manage work allocation based on portfolios rather than direct claim-by-claim assignments. You will utilize Excel spreadsheets (e.g., Aligned Scope, payer-specific correspondence lists) to pivot through data, tag opportunities, and work claims efficiently.
• Navigate Proprietary Systems: Utilize internal systems including Nautilus (accounting & billing), Reggie (patient registration), and Nova (incoming AI workflow tool) to manage accounts.

What You Bring

• Revenue Cycle Knowledge: Experience with insurance payers, Coordination of Benefits (COB), and general collections.
• Tech-Savviness: Strong proficiency in Excel (including pivoting and filtering data) and the ability to quickly learn proprietary software systems.
• Critical Thinking & Problem-Solving: Ability to navigate ambiguous workflows and independently investigate root causes without requiring a rigid playbook.
• Adaptability & Learning Agility: Capable of handling shifting portfolio priorities and adapting to upcoming system updates and technological changes anticipated over the next 18 months.
• Resourcefulness: Willingness and confidence to make proactive outreach calls to employer groups and insurance payers to resolve stuck accounts.

Preferred Qualifications:

• Prior experience in account resolution.
• Specific experience handling credit and debt portfolios.
• Extensive Healthcare Accounts Receivable (AR) experience.

Performance Expectations & Work Environment

• Performance Targets: Primary goal is ~$400,000 resolved per month. This is tracked as a lag metric over several months, with evaluations heavily focused on account resolution and touch efficiency rather than simple activity volume (MPIs/patient touches).
• Work Schedule (Hybrid):
• Month 1: 1-2 days for setup and online training, followed by 2-3 consecutive days on-site for intensive hands-on training. Remaining days are remote.
• Month 2 and beyond: Approximately 3 on-site days per month for hands-on check-ins and team collaboration, with the remaining days worked remotely.

Compliance Requirements

All offers are contingent upon the successful completion of the following pre-employment checks:

• Background Check: Includes verification of education completion (diploma, GED, or degree) and past employment verification.
• Drug Screen: Mandatory screening (Note: marijuana is included in the testing panel).