Health Claims Collections Specialist

Virtual Vocations Inc · Workfromhome, United States

Resolving complex post-payment and denied DME claims, the full-time Health Claims Collections Specialist will manage high-priority accounts, conduct payer trend analysis, and assist in driving revenue recovery while working remotely. Key responsibilities Independently manage a portfolio of complex claims requiring advanced solutions and strategies Analyze denials and execute action plans, including appeals and payer outreach Identify payer trends and escalate issues with supporting data to leadership Required qualifications High School Diploma or Equivalent Experience Minimum 2+ years of medical collection or revenue cycle experience, specifically with DME or orthopedic claims Advanced knowledge of payer guidelines and appeals processes Proficiency in reading and interpreting EOBs and payer policies Strong working knowledge of ICD-10, HCPCs, and CMS-1500 billing procedures