RCM Collection Specialist at Aleracare – Sandy, Utah

About PURE

Pure Infusion Suites is a fast-growing healthcare start-up, recognized as the fastest-growing company in Utah as of October 2024. Our success comes from our remarkable team, shared values, and a supportive culture that shows in every interaction, whether with patients in our clinics or with insurance companies and vendors at our corporate headquarters. If you are detail-oriented, self-directed, and passionate about ensuring claims are processed quickly and accurately, this could be the perfect role for you.

OUR CORE VALUES
We live by four core values that define our culture and guide our hiring:

· People-obsessed

· Passionate

· Builder

· Grateful

Collection Specialist Position Summary: The Collector Specialist supports the collections department by performing daily tasks related to insurance follow-up, patient collections, denial resolution, and accounts receivable (A/R) management. This entry-level role contributes to reducing days in A/R, minimizing denials, improving collection rates, and supporting optimal cash flow for healthcare providers. The position requires strong attention to detail, persistence, organizational skills, and a team-oriented approach while learning industry processes and payer requirements.

Key Responsibilities

· Perform insurance follow-up on outstanding claims, including contacting payers to check claim status, resolve unpaid or underpaid accounts, and request additional information as needed.

· Assist with patient collections by making outbound calls, sending statements, and following up on self-pay balances while maintaining professionalism and empathy.

· Review and work aging A/R reports under guidance, prioritizing accounts based on age, dollar amount, and payer type to ensure timely resolution.

· Support denial management by identifying basic denial reasons, preparing simple appeals or resubmissions, and documenting corrections in the billing system.

· Direct adjustments, and denials accurately to patient accounts and reconcile as directed.

· Respond to patient and payer inquiries regarding bills, insurance coverage, and account status in a timely and courteous manner.

· Collaborate with team members and other departments (e.g., billing, coding, or registration) to gather information needed to resolve accounts.

· Maintain accurate documentation of all collection activities, communications, and account notes in the revenue cycle system.

· Adhere to healthcare regulations (HIPAA, CMS guidelines, payer contracts) and internal policies to ensure compliance and patient confidentiality.

· Participate in training sessions to learn payer policies, billing systems, and best practices in medical collections.

· Assist with basic quality assurance tasks, such as reviewing own work for accuracy under supervision.

· Track personal productivity metrics and contribute to team goals for collections and A/R resolution.

Required Knowledge, Skills, and Abilities

· Basic understanding of medical billing, insurance claims processing, and collections workflows (training provided).

· Familiarity with major payers (e.g., Medicare, Medicaid, commercial insurers) and common reimbursement processes is a plus but not required.

· Strong attention to detail, organizational skills, and ability to prioritize tasks in a fast-paced environment.

· Good verbal and written communication skills for interacting with patients, payers, and team members.

· Customer service orientation with professionalism, especially when discussing sensitive financial matters.

· Proficiency with computers, including Microsoft Office and willingness to learn revenue cycle management systems and reporting tools.

· Ability to follow instructions, work independently on routine tasks, and escalate complex issues appropriately.

· Commitment to confidentiality, regulatory compliance, and ethical standards.

Education, Experience, and Requirements

· High School Diploma or equivalent required; additional education or certifications in medical billing/collections.

· 3+ years of experience in medical billing, collections, customer service, or a related healthcare/revenue cycle role; preferably in specialty infusion therapy or complex outpatient services.

· Entry-level candidates welcome with strong willingness to learn.

· Must meet U.S. employment eligibility requirements