Top 11776 Commercial Insurance Collections Jobs

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- Microsoft Outlook
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Atrium —Little Falls, NJ
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Remote Commercial Collections LARGE BALANCE
Greenberg Grant & Richards Inc —Buffalo, NY
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Revenue Cycle Home Infusion Collections Specialist (CPR+ Software Experience Required)

Apex Infusion Pharmacy
Signal Hill, CA

Quick Apply

Job Details

Full-time
$25 - $30 an hour

Benefits

Health savings account
Paid holidays
Health insurance
Paid time off
Parental leave
401(k) matching
Opportunities for advancement
Flexible schedule
Referral program
Retirement plan

Qualifications

Revenue cycle management
Appeals
Accounts receivable
Microsoft Outlook
Medicare
Managed care
Accounts receivable management
Medical software
Spreadsheets
Research
IV infusion
Medicaid health insurance
ICD-10
HCPCS
Medicare regulations
Medical billing
Medical insurance appeals management
Organizational skills
Medicaid regulations
Medicaid
Insurance claims appeal handling
Aging report preparation
Medical terminology
Medical debt collection accounts

Full Job Description

Home Infusion Medical Collections Specialist (CPR+ Experience Required)

Salary: Competitive, based on experience

About Us

We are a growing home infusion pharmacy dedicated to providing exceptional patient care while maintaining the highest standards of billing accuracy and reimbursement. We are seeking an experienced, detail-oriented Medical Collections Specialist with home infusion billing and CPR+ software experience to join our Revenue Cycle team.

Position Summary

The Medical Collections Specialist is responsible for managing and resolving outstanding insurance claims, following up with commercial, Medicare, and Medicaid payers, appealing denied claims, and ensuring timely reimbursement. The ideal candidate has a strong understanding of home infusion reimbursement and can work independently in a fast-paced environment.

Essential Responsibilities

Follow up on outstanding insurance claims to ensure prompt payment.
Investigate and resolve claim denials, rejections, and underpayments.
Prepare and submit first- and second-level appeals.
Work directly with insurance companies to resolve claim issues.
Review Explanation of Benefits (EOBs), Electronic Remittance Advices (ERAs), and payer correspondence.
Identify billing errors and coordinate corrections with the billing team.
Maintain accurate documentation of all collection activities within CPR+.
Monitor aging reports and prioritize accounts for follow-up.
Meet departmental productivity and collection goals.
Maintain compliance with HIPAA and all applicable payer regulations.
Collect outstanding insurance balances for home infusion and specialty pharmacy claims.
Follow up with Medicare, Medicaid, and commercial insurance carriers regarding unpaid, denied, and underpaid claims.
Analyze EOBs, ERAs, payer correspondence, and denial reasons.
Prepare and submit first-level, second-level, and external appeals.
Resolve authorization, medical necessity, coding, coordination of benefits, and timely filing issues.
Research payer policies and identify opportunities for additional reimbursement.
Work closely with billing, intake, authorization, pharmacy, and clinical staff to resolve claim issues efficiently.
Maintain complete documentation of all collection activities in CPR+.
Prioritize aged accounts to maximize cash collections.
Meet or exceed monthly productivity and collection goals while maintaining quality standards.
Ensure compliance with HIPAA, Medicare, Medicaid, and payer guidelines.

Required Qualifications

Minimum of 2 years of medical collections experience in a home infusion pharmacy or specialty pharmacy.
Hands-on experience with CPR+ software is required.
Strong knowledge of Medicare, Medicaid, and commercial insurance reimbursement.
Experience appealing denied claims and resolving complex billing issues.
Knowledge of HCPCS, CPT, ICD-10, modifiers, and medical necessity requirements.
Excellent communication, organization, and problem-solving skills.
Ability to manage multiple priorities while meeting deadlines.
Proficiency with Microsoft Office applications, particularly Excel and Outlook.

Preferred Qualifications

CPR+ experience is required. Home infusion pharmacy experience is strongly preferred.
Experience with Waystar or other medical claims clearinghouses.
Knowledge of infusion therapy billing and reimbursement.
Familiarity with payer portals and electronic claim status systems

Candidates with experience collecting claims for the following therapies are highly encouraged to apply:

IVIG
Biologic therapies
Autoimmune disease infusions
Neurology infusions
Rheumatology infusions
Gastroenterology infusions
Oncology supportive care
Specialty injectable medications

What We Offer

Competitive salary (based on experience)
Paid Time Off (PTO)
Paid Holidays
Health Insurance
401(k) with company match
Opportunities for professional growth and advancement
Supportive, team-oriented work environment

Schedule

Full-time
Monday through Friday
Day Shift

Work Location

On-site

If you are an experienced medical collections professional with CPR+ home infusion experience and are passionate about maximizing reimbursement while supporting quality patient care, we encourage you to apply.

Job Type: Full-time

Pay: $25.00 - $30.00 per hour

Expected hours: 40.0 per week

Benefits:

401(k) matching
Flexible schedule
Health insurance
Health savings account
Paid time off
Parental leave
Referral program
Retirement plan

Experience:

Infusion Pharmacy and CPR + Software: 2 years (Required)

Work Location: In person

Quick Apply

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