Healthcare Collections Specialist

Join AIS Healthcare

AIS Healthcare is the leading provider of Targeted Drug Delivery (TDD) and Infusion Care solutions. Guided by our core values of Innovation, Stewardship, and Unity, we are committed to Advancing Quality and Improving Lives for the patients, providers, and communities we serve.

As a national leader in specialty pharmacy and infusion services, AIS Healthcare partners with providers and healthcare organizations to deliver exceptional patient outcomes through innovative therapies, nursing support, and care coordination services.

We're seeking an experienced Healthcare Collections Specialist to join our Financial Services team. This role is ideal for a healthcare collections professional who enjoys resolving complex reimbursement issues, appealing denials, maximizing claim reimbursement, and working collaboratively across departments to achieve results.

Why Join AIS Healthcare?

We offer a comprehensive benefits package, including:

• 100% Remote Work Opportunity
• Medical, Dental, and Vision Insurance
• Life Insurance
• Long-Term Disability Insurance
• Competitive Paid Time Off
• 401(k) with Generous Employer Contribution
• Career Growth Opportunities
• Supportive and Collaborative Team Culture

Position Summary

The Healthcare Collections Specialist is responsible for managing collection activities for Targeted Drug Delivery (TDD) services. This includes reimbursement follow-up, denial management, contract analysis, appeals, payment investigation, and resolving billing-related issues with insurance carriers and other responsible parties.

Successful candidates will have strong healthcare collections experience and a thorough understanding of medical billing, reimbursement methodologies, and revenue cycle operations.

What You'll Do

• Follow up on submitted claims to ensure prompt and accurate payment
• Investigate and resolve denied, underpaid, or unpaid claims
• Analyze payments and denials to ensure appropriate reimbursement
• Research and resolve payment discrepancies
• Initiate and manage appeals to maximize reimbursement
• Process account adjustments, write-offs, and refund requests in accordance with company policies
• Investigate and resolve overpayments and duplicate payments
• Collaborate with internal departments to obtain information required for payment resolution
• Verify billing accounts against the accounts receivable ledger to ensure accuracy
• Maintain detailed documentation of all payer communications and account activity
• Resolve denial issues within established turnaround times
• Ensure compliance with HIPAA, payer regulations, and federal and state requirements
• Identify opportunities to improve reimbursement and reduce outstanding accounts receivable
• Serve as a resource and team player by sharing knowledge and supporting colleagues

Required Qualifications

• High School Diploma or GED
• 3-5 years of healthcare industry experience
• 3-5 years of medical billing and insurance collections experience
• Strong understanding of Revenue Cycle Management functions
• Knowledge of medical terminology, insurance plans, reimbursement methodologies, and collection practices
• Working knowledge of ICD-9 and ICD-10 coding
• Experience with denial management, appeals, and reimbursement follow-up
• Strong analytical, investigative, and problem-solving skills
• Excellent verbal and written communication skills
• Ability to work independently in a remote environment
• Proficiency in Microsoft Outlook, Word, and Excel

Preferred Qualifications

• Home Infusion experience
• Intrathecal Pain Management experience
• Specialty healthcare or infusion reimbursement experience
• Knowledge of NDC codes and infusion-related supplies and services

To be considered for this position, you must complete the Culture Index Assessment.

Important: Applications will not be reviewed until the assessment has been completed.

Culture Index Assessment:
http://portal.cultureindex.com/public/survey/general/0BFB8F0000 

The assessment takes less than 10 minutes to complete and only needs to be completed once.

If the assessment link does not open when clicked, please copy and paste the URL directly into your web browser. If you continue to experience issues, try using a different browser.

About AIS Healthcare

AIS Healthcare is the nation's leading provider of advanced sterile, patient-specific intrathecal pump medications and in-home infusion therapies. Through innovative pharmacy services, specialized nursing care, and comprehensive care coordination, we partner with providers to deliver exceptional patient outcomes and experiences.

We offer a wonderful work culture and are looking for an impact player who is positive, hardworking, collaborative, and committed to delivering exceptional results.

AIS Healthcare | Advancing Quality. Improving Lives.