Job Closed
This listing is no longer active.
Experienced Medical Insurance Collection Specialist
Location
United States
Posted
76 days ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
Experienced Medical Insurance Collection Specialist
AIS Healthcare
This is a 100% remote opportunity; however, please only apply if you have3 to 5 years of medical insurance collections experience. AIS Healthcare is the leading provider of Targeted Drug Delivery (TDD) and Infusion Care. With our diverse culture, and our values around Innovation, Stewardship, and Unity, we are committed to Advancing Quality and Improving Lives. We are dedicated to doing more for our patients by providing quality products and services that enhance the entire care experience. AIS Healthcare is looking for experienced and motivated Accounts Receivable Collection experts to join our dynamic team! The AR Collection role is a full-time position responsible for collection processes for TDD services that includes contract analysis, reimbursement, denial management, appeals and resolving billing-related issues with insurance companies or other responsible party for services rendered. The perfect candidate should have an in-depth knowledge of collection practices related to billing and collection activities. AIS Healthcare offers great benefits, including health, vision and dental insurance, long term disability insurance, life insurance, a vacation package, and a 401K plan with a generous employer contribution. Additionally, we offer a 100% work from home model. EDUCATION AND EXPERIENCE: - A high school diploma or general education degree (GED) equivalent is required. - 3-5 years of healthcare industry experience required. - 3-5 years of medical billing and collections experience required. - Home Infusion, Intrathecal Pain Management experience preferred. ESSENTIAL DUTIES AND RESPONSIBILITIES: - Recognizes patients’ rights and responsibilities and supports them in the performance of job duties, respects patient’s rights to privacy and confidentiality. - Follows up on invoices submitted to ensure prompt and timely payment and escalates issues, as necessary. - Evaluates payments/denials received for correctness and ensures they are applied accordingly. - Identifies bad debt write-offs and A/R adjustments. Initiates write-offs and adjustments in accordance with policies and procedures. - Identifies any overpayments and/or duplicate payments and investigates and resolves accordingly. - Processes refund requests, in accordance with policies and procedures. - Maintains contact with other departments to obtain patient or insurance information needed for claim payment. - Responsible for understanding all procedures within regulatory mandates. - Ensures that the activities of the collection operations are conducted in a manner that is consistent with overall department protocol, and are following Federal, State, and payer regulation, guidelines, and requirements. - Makes calls to troubleshoot payment discrepancies and establish resolution. - Documents, in detail, phone calls, phone number, person spoken to, and call details on a consistent basis. - Consistently looks for areas to maximize claim reimbursement. - Resolves issues that created a denial within 5 days of receipt of denial. - Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations. - Maintains understanding of NDC (National Drug Code) numbers, metric quantities, and knowledge of infusion supplies. - Maintains a broad range of knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes. - Shares knowledge gained with other staff members and works as a team member. - Interacts with others in a positive, respectful, and considerate manner. - Performs other job-related duties as assigned. QUALIFICATION REQUIREMENTS: - Ability to recognize, evaluate and exercise good judgment in solving complex situations and advising in accordance with laws and regulations. - Excellent verbal and written communication and relationship building skills with an ability to prioritize, negotiate, and work with a variety of internal and external stakeholders. - Strong work ethic with personal qualities of integrity and credibility. - Self-directed, detail oriented, conscientious, organized, and able to follow through. - Ability to deal in an organized manner with problems involving multiple variables within the scope of the position. - Tolerant of frequent interruptions and distractions from staff and other internal support teams. - Proficient in Microsoft Office, including Outlook, Word, and Excel. Steps to Apply: To apply for this role, you must complete a Culture Index Assessment to be considered.Please note that your application will not be considered if the Assessment is not completed. Copy and paste the following link into your browser and press enter. Then, select the corresponding position for which you are applying. (Only one assessment per candidate is required.) The assessment is brief, taking less than ten minutes to complete. portal.cultureindex.com/public/survey/general/0BFB8F0000 AIS HealthCare™is the leading provider of advanced sterile, patient-specific intrathecal pump medications and in-home intravenous infusion, including immune globulin therapies. These services, combines with your advanced nursing and care coordination solutions, assist physicians and hospitals in delivering a superior level of care for optimal therapeutic outcomes. We offer a wonderful work culture, looking for an impact player who is positive, earnest, and hardworking.
Related Guides
Related Categories
Related Job Pages
More Insurance Jobs
Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day. Medical Insurance Collections Specialist Location: Fully Remote Schedule: Monday–Friday, 9:00 AM – 5:30 PM EST - No weekends Training Schedule: 6 weeks 9:00am-5:30pm EST Pay Rate: Starting at $18 an hour DOE- please note this rate may be below your state’s minimum wage. Consider this when applying. Job Summary The Insurance/Collections Specialist is responsible for identifying, analyzing, and recovering overpaid medical claims from healthcare providers, third parties, and insurance carriers. This role includes resolving discrepancies related to coordination of benefits (COB), duplicate payments, and other claim errors through research, communication, and follow-up. This position requires managing a high volume of calls, maintaining positive provider relationships, and ensuring timely resolution of accounts while meeting performance standards for collections, compliance, and productivity. Key Responsibilities - Recover medical claim overpayments through phone, email, and fax outreach - Analyze claims data to identify overpayments and determine recovery actions - Handle provider disputes, appeals, and complex collection scenarios - Coordinate with clients and providers to process adjustments and reversals - Maintain accurate follow-ups to ensure timely resolution - Develop effective collection strategies to maximize recovery - Communicate clearly with internal teams and external partners Required Experience & Knowledge - Minimum 2 years of medical billing and/or insurance collections experience and account management - Strong understanding of: - Medical claims processing and reimbursement - Medicare (Parts A, B, C, D), Medicaid, and commercial insurance - Coordination of Benefits (COB) - Claim denials, appeals, and rebilling processes - Explanation of Benefits (EOB) and Electronic Remittance Advice (ERA) - CPT and ICD-9/10 coding - Healthcare settings (inpatient, outpatient, pharmacy, etc.) - Ability to identify and explain overpayment types (duplicates, contractual, PPO, bundled claims, etc.) Skills & Requirements - Must be able to successfully complete a background check and drug screening - Associate degree or equivalent combination of education and experience - Strong analytical, organizational, and problem-solving skills - Excellent verbal and written communication - Ability to manage high call volume and work independently - Proficiency in Microsoft Office (Word, Excel, Outlook) - Strong customer service and negotiation skills Requirements: - Must pass an internet speed test (download equal to or greater than 25, upload equal to or greater than 5, Ping ms equal to or less than 175) - Must have the ability to connect with an ethernet cable to a modem/router - Live in one of the following states, AL, AR, AZ, CO CT, DE, FL, GA, ID, IN, IA, KS, KY, LA, ME, MI, MS, MO, NE, NV, NH, NJ,NM, NC, OH, OK, PA, RI, SC, SD, TN, TX,UT, VT, VA, WA, WV, WI, WY We are currently NOT hiring in the following geographies, included but not limited to: States: AK, CA, CT, HI, MA, IL, MT & NY Metro Areas: MN – Minneapolis, IL – Chicago, NY – New York City, OR - Portland, MD - Montgomery County, WA - Seattle, Washington, DC Due to varying state and local minimum wage laws, we are currently only able to hire candidates residing in states where our compensation structure complies with applicable wage regulations. As a result, we may be unable to consider applicants from certain states or municipalities at this time. Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated hourly rate is $18.00. Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form. Complete the form and then email it as an attachment to FTADAAA@conduent.com. You may also click here to access Conduent's ADAAA Accommodation Policy.
Division or Field Office: Underwriting Division Department of Position: Field Commercial Mgmt Dept Work from: Home in Illinois Salary Range: $97,388.00 - $155,567.00 * salary range is for this level and may vary based on actual level of role hired for *This range represents a national range and the actual salary will depend on several factors including the scope and complexity of the role and the skills, education, training, credentials, location, and experience of an applicant, as well as level of role for which the successful candidate is hired. Position may be eligible for an annual bonus payment. At Erie Insurance, you’re not just part of a Fortune 500 company; you’re also a valued member of a diverse and inclusive team that includes more than 6,000 employees and over 13,000 independent agencies. Our Employees work in the Home Office complex located in Erie, PA, and in our Field Offices that span 12 states and the District of Columbia. Benefits That Go Beyond The Basics We strive to be Above all in Service® to our customers—and to our employees. That’s why Erie Insurance offers you an exceptional benefits package, including: - Premier health, prescription, dental, and vision benefits for you and your dependents. Coverage begins your first day of work. - Low contributions to medical and prescription premiums. We currently pay up to 97% of employees’ monthly premium costs. - Pension. We are one of only 13 Fortune 500 companies to offer a traditional pension plan. Full-time employees are vested after five years of service. - 401(k) with up to 4% contribution match. The 401(k) is offered in addition to the pension. - Paid time off. Paid vacation, personal days, sick days, bereavement days and parental leave. - Career development. Including a tuition reimbursement program for higher education and industry designations. Additional benefits that include company-paid basic life insurance; short-and long-term disability insurance; orthodontic coverage for children and adults; adoption assistance; fertility and infertility coverage; well-being programs; paid volunteer hours for service to your community; and dollar-for-dollar matching of your charitable gifts each year. Position Summary This is a high-impact leadership role where you’ll develop agents and District Sales Managers, help shape regional growth strategies, and make your mark at one of the most respected companies in the industry. The ideal candidate will live in the state of Illinois while working remotely. This position comes with a company car with paid gas card. What You’ll Do - Partner with branch leaders to set and achieve growth, profitability, and agency development goals. - Serve as a hands-on mentor to Agents and District Sales Managers, building expertise in ERIE’s commercial lines products and underwriting practices. - Evaluate complex commercial accounts, make underwriting and pricing decisions within authority, and collaborate with senior underwriters on larger risks. - Foster strong relationships with Agents, branch teams, and Home Office underwriting partners. - Represent ERIE in the community and maintain positive relationships with policyholders and stakeholders. Who You Are You’re a strategic thinker who leads with influence, not just authority. You enjoy rolling up your sleeves to develop others and have the commercial acumen to guide agents toward success. You’re comfortable making judgment calls on complex accounts and thrive on balancing growth with sound underwriting. In addition, this position trains, develops and guides Agents and district sales managers (DSM) in a designated branch territory in the promotion and sale of commercial lines products, providing assistance in the areas of production, product knowledge and application, and underwriting. Establishes and maintains relationships with branch managers and Agents to improve Agent willingness and ability to pursue and place quality commercial business with the ERIE. Duties and Responsibilities - Assists branch managers in establishing short- and long-range objectives related to commercial lines sales, with an emphasis on growth, underwriting profitability and agency development and training. - Provides hands-on training and guidance to Agents on ERIE's commercial lines products, resources, and services, including identifying web-based resources and training programs for Agent use. Builds commercial expertise of new and existing Agents for increased independence and sound judgment when pursuing commercial business. - Provides hands-on training and guidance to branch DSMs on ERIE's commercial lines products, resources, and services, including identifying web-based resources and training programs. Builds commercial expertise of new and existing DSMs for increased independence and sound judgment when working with Agents to pursue commercial business. - Identifies Agents requiring additional guidance and interaction from their DSMs on commercial lines products and services. Works directly with DSMs, branch managers, and commercial underwriting staff to develop a plan to deliver that guidance and interaction as appropriate. - Contacts and visits Agents regularly to evaluate quotations and applications for multiple commercial lines to determine acceptability, including larger, more complex commercial accounts. - Makes acceptability and pricing decisions on risks within defined binding authority. Refers risks that are beyond binding authority to a senior commercial lines underwriter, risk analyst or underwriting supervisor. - Develops and maintains effective relationships and contact with Home Office commercial lines underwriting management and production underwriters. - Serves as a company representative in maintaining favorable Policyholder relationships. Works closely with adjusters and other claims personnel on matters of mutual concern. - Develops and maintains strong working knowledge of ERIE's commercial product lines, including policy features and key endorsements and sources of information on ERIE's products. - Represents the company in community relations activities as directed. - For branch office accounts, handles insurance agency business as a licensed, non-commission company Agent. The first 7 duties listed are functions identified as essential to the job. Essential functions are those job duties that must be performed in order for the job to be accomplished. This position description in no way states or implies that these are the only duties to be performed by an incumbent. Employees are required to follow any other job- related instruction and to perform any other duties as requested by their supervisor, or as become evident. Capabilities - Values Diversity - Nimble Learning - Self-Development - Collaborates - Customer Focus - Cultivates Innovation - Instills Trust - Optimizes Work Processes (IC) - Decision Quality - Ensures Accountability Qualifications Minimum Educational and Experience Requirements - Bachelor’s degree, and six years of sales, underwriting, claims, loss control or marketing experience required; or - Associate’s degree and eight years of sales, underwriting, claims, loss control or marketing experience, required; or - High school diploma or GED and ten years of sales, underwriting, claims, loss control or marketing experience, required. Additional Experience - Incumbent must live in territory assigned unless a change is approved by the company. - Occasional overnight travel required. - Acceptance of hours beyond the normal work week and some restrictions on vacation during peak periods. Designations and/or Licenses - Willingness to obtain property/casualty insurance license for assigned state or branch office service territory required. - Valid driver's license and good driving record required. - One of the following professional designations is preferred: ARM, AU, ALCM, CRM, CIC, CPCU, or General Insurance Program. Physical Requirements - Lifting/Moving 0-20 lbs; Occasional (<20%) - Lifting/Moving 20-50 lbs; Occasional (<20%) - Ability to move over 50 lbs using lifting aide equipment; Occasional (<20%) - Driving; Often (20-50%) - Pushing/Pulling/moving objects, equipment with wheels; Occasional (<20%) - Manual Keying/Data Entry/inputting information/computer use; Often (20-50%) - Climbing/accessing heights; Rarely
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. *Able to work remote anywhere in the United States, Monday - Friday; 8:00AM - 6:00PM CST. Targeted start date for this role is 5/11/26.* Position Purpose: Obtain and verify complete insurance information, including the prior authorization process, copay assistance and coordination of benefits. - Obtain and verify insurance eligibility for services provided and document complete information in system - Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies - Collect any clinical information such as lab values, diagnosis codes, etc. - Determine patient’s financial responsibilities as stated by insurance - Configure coordination of benefits information on every referral - Ensure assignment of benefits are obtained and on file for Medicare claims - Bill insurance companies for therapies provided - Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures - Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs - Handle inbound calls from patients, physician offices, and/or insurance companies - Resolve claim rejections for eligibility, coverage, and other issues - Performs other duties as assigned - Complies with all policies and standards Education/Experience: High school diploma with 1+ years of medical billing or insurance verification experience. Bachelor’s degree in related field can substitute for experience. Experience with payors and prior authorization preferred. Pay Range: $15.87 - $27.25 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
• Engage with new and existing customers, through inbound and outbound interactions, delivering life insurance solutions. • Access daily leads—2025 YTD averages include 212 outbound calls, 734 web inquiries, and 309 upgrades. • Cross-Training Opportunities: Expand your skillset with special incentives and multiple business queues.

