Collections Specialist II, Home Infusion

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Job Description:

  • Manage third-party billing and collections activities
  • Investigate and resolve claim denials, rejections, and underpayments
  • Submit payer appeals and monitor timely follow-up
  • Review claims, EOBs, and patient accounts to determine appropriate next steps
  • Correct and reprocess claims for reimbursement when necessary
  • Document collection efforts and actions taken on accounts
  • Communicate with payers, patients, and internal teams to resolve outstanding balances
  • Maintain quality, productivity, and compliance standards
  • Perform other duties as assigned
  • Support CarepathRx within Evernorth Health Services’ Pharmacy and Care Delivery organization

Requirements:

  • High school diploma or equivalent
  • 3+ years of medical collections, billing, or healthcare revenue cycle experience
  • Knowledge of insurance reimbursement, claim processing, and payer guidelines
  • Understanding of ICD-10, CPT, HCPCS, and medical terminology preferred
  • Home infusion, Medicare, or DME billing experience preferred
  • Strong problem-solving, organizational, and communication skills
  • Ability to work independently, manage multiple priorities, and maintain attention to detail
  • Proficiency with Microsoft 365 (Outlook, Teams, Excel)
  • For home working, internet connection through a cable broadband or fiber optic internet service provider with at least 10Mbps download/5Mbps upload

Benefits:

  • Annual bonus plan eligibility
  • Medical insurance
  • Vision insurance
  • Dental insurance
  • Well-being and behavioral health programs
  • 401(k)
  • Company-paid life insurance
  • Tuition reimbursement
  • Minimum of 18 days of paid time off per year
  • Paid holidays
  • Leaves of absence
  • Cable broadband or fiber optic internet service with at least 10Mbps download/5Mbps upload for home working
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