This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a CSI Revenue Cycle Collector based in the United States.
This is a specialized revenue cycle and medical collections role focused on ensuring accurate reimbursement and resolution of complex medical claims within a specialty pharmacy and infusion billing environment. The position plays a key role in maintaining financial performance by managing claim follow-ups, resolving denials, and coordinating with payers, patients, and healthcare providers. You will work across the full lifecycle of medical claims, from initial billing issues through appeals and payment resolution, ensuring compliance with regulatory and contractual requirements. The role requires strong analytical thinking, attention to detail, and the ability to navigate complex insurance processes. It is well suited for a professional who thrives in structured, detail-heavy environments and understands the nuances of healthcare reimbursement systems. This position has a direct impact on revenue integrity and operational efficiency.
Accountabilities:
- Follow up on outstanding medical claims with insurance companies, patients, and healthcare providers to ensure timely resolution and payment.
- Communicate with payers to resolve billing disputes, denials, and reimbursement issues in accordance with contractual guidelines.
- Maintain accurate and detailed electronic records of all communications, claim actions, and payer interactions.
- Analyze and interpret Explanation of Benefits (EOBs) to identify payment discrepancies and required corrective actions.
- Manage and resolve denied claims, including initiating and supporting the appeals process with appropriate documentation.
- Process refund requests and revenue adjustments accurately and in a timely manner when required.
- Ensure all claims handling activities comply with applicable industry regulations, payer contracts, and HIPAA requirements.
- Collaborate with internal teams to support efficient revenue cycle operations and maintain financial accuracy.
Requirements:
- High school diploma or GED required; college degree preferred or equivalent relevant experience.
- 1–3 years of experience in medical billing, revenue cycle, or collections, preferably within infusion or specialty pharmacy environments.
- Strong knowledge of infusion medical billing codes, insurance regulations, and payer contract structures.
- Familiarity with pharmacy or medical insurance claims, denials, and appeals processes.
- Experience with CareTend preferred.
- Strong attention to detail with excellent analytical and problem-solving skills.
- Ability to multitask and adapt quickly to changing priorities in a fast-paced environment.
- Strong time management and organizational skills.
- Effective communication skills and ability to collaborate with internal and external stakeholders.
- Understanding of HIPAA regulations and commitment to compliance standards.
Benefits:
- Competitive compensation aligned with experience and industry standards.
- Comprehensive healthcare coverage options (medical, dental, and vision).
- Stable full-time employment with a 40-hour work week.
- Opportunities to work in a specialized healthcare revenue cycle environment.
- Paid time off and standard company holidays (where applicable).
- Exposure to specialty pharmacy and infusion billing operations, supporting professional growth.
- Structured and regulated work environment focused on compliance and accuracy.
- Equal employment opportunity workplace with inclusive hiring practices.