Pharmacy Accounts Receivable Collections Specialist
Core
Manage high-volume insurance and patient accounts receivable, process claims research and appeals, and resolve denials to support revenue cycle performance.
Role type
Senior Associate AR Collections Specialist
Builds
Accounts receivable resolution and claim adjustments for specialty pharmacy and medical services
Domain
Healthcare / Pharmacy / Insurance Billing
Required skills
Insurance collections, Claims research and appeals, Denial processing, Medicare/Medicaid billing, EOB and remittance advice interpretation, High-volume account management, Payer policy knowledge
Preferred skills
Specialty pharmacy collections, Oncology therapy reimbursement, Commercial and governmental payer portal experience, HCPCS/NDC coding
Technologies
Microsoft Office, Excel, Payer clearinghouse portals
Responsibilities
Prioritize and manage high-volume accounts receivable based on claim age and complexity; Analyze complex insurance and patient accounts outstanding over 31 days; Investigate denials, overpayments, and rejections; Process approved account adjustments and issue refunds; Respond to patient and payer inquiries regarding balances and claims; Document collection activity and account disposition accurately.
Seniority
Senior, hands-on IC