Collections Specialist (Facility & Freestanding Emergency) | Permanent WFH

We are looking for an experienced Medical Collections Specialist with a strong background in Facility & Freestanding Emergency. The Collections Specialist is responsible for timely and accurate claims filing, review, and resolution of denied insurance claims. Accounts Receivable Collections Specialist will review all pertinent information such as provider medical records, service claims, insurance carrier explanation of benefits, insurance carrier denial letters, and electronic remits to ensure that payments and denials are worked promptly and appeals for the denied claims are submitted appropriately.

Key Responsibilities:

• Monitor claims volume, deadlines, and collection efforts to ensure workflows are followed.
• Process and follow up on denials, rejections, and appeals promptly.
• Research and resolve payment errors or claim issues.
• Track emails and correspondence to ensure timely collection responses, negotiations, and mediations.
• Monitor internal tracking documents for timeliness and efficiency.
• Manage weekly invoicing to ensure accounts and payments are accurate.
• Conduct audits of workflows and processes; identify training needs and report to leadership.
• Schedule, prepare, and conduct mediations; track trends for process improvements.
• Audit team performance to ensure productivity and quality goals are met; address variances.
• Provide training and education as needed.
• Ensure compliance with healthcare regulations, privacy laws, and billing standards.
• Perform other duties as assigned.

• Minimum of 3 years’ experience in collections, denials management, NSA, IDR, TDI, and negotiations, preferably in a free-standing emergency room facility setting.
• In-depth knowledge of healthcare regulations, privacy laws, and billing requirements.
• Strong billing and coding background, with preference for free-standing emergency room experience.
• Excellent communication and interpersonal skills.
• Ability to analyze data, identify trends, and make data-driven decisions.
• Proficient in healthcare information systems and patient access software.
• Demonstrated experience in process improvement and best practice implementation.
• Amenable to work during U.S. business working hours.

Work-from-Home Device Requirement:

• Device: Personal computer with Intel Core i5 or higher, or AMD Ryzen 5 or higher
• Internet: Wired connection with at least 50 Mbps download speed, plus a backup connection (e.g., mobile hotspot or prepaid Wi-Fi)
• Work Environment: Quiet, well-lit space with minimal background noise

• Permanent Work From Home
• Weekly Paychecks
• Fixed Weekends Off
• HMO Reimbursement on your 90th day
• Thriving Company Culture with Complete Autonomy
• Exclusive Specialized Training Programs
• Unlock Your Potential with a Highly Competitive Salary

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Who are we?

MedCore Solutions is the healthcare division of BizForce, dedicated to supporting U.S.-based healthcare clients through a skilled remote workforce in the Philippines. We specialize in connecting top clinical and administrative talent with reputable healthcare organizations, ensuring high-quality care delivery while providing rewarding work-from-home careers.

Why work for Bizforce? 

Bizforce is a global remote workforce solutions company currently partnering with some of the largest Architectural and Engineering firms in the world. If you are looking to advance your career and improve your skills with an industry leader, we encourage you to apply today! Bizforce was founded with one goal – to deliver dependable high-quality skilled labor and business processes to US-based companies at affordable prices. Bizforce has grown rapidly and allows the best talent in PH to work remotely from home with the latest technology and resources. BizForce is proud to partner with PH to deliver qualified, professional workers, giving our Architects and Engineers the ability to have an unbeatable career and work from home.