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Medical Collections Specialist
LUX Infusion. Follow up on submitted insurance claims to ensure accurate and timely reimbursement .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical collections and revenue-cycle management, with a strong focus on resolving insurance claims and maintaining compliance with billing regulations. Proficient in utilizing healthcare billing platforms and collaborating with cross-functional teams to ensure timely reimbursement.
Highest-signal resume keywords
Medical Collections ExperienceInsurance Claims ResolutionHealthcare Billing PlatformsStrong Analytical SkillsExcellent Communication Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical CollectionsClaims InvestigationReimbursement MethodologiesData EntryBilling RegulationsCoding GuidelinesPayer Follow-UpDocumentation MaintenanceMetrics-Driven EnvironmentRevenue-Cycle Responsibilities
Soft Skills
Attention to DetailProblem-Solving SkillsCustomer-Service MindsetPersistenceProfessionalism
Tools & Technologies
Microsoft OfficeBilling SystemsClearinghousesRevenue-Cycle Systems
Certifications & Qualifications
High School DiplomaGED
Industry Keywords
Insurance PayersClaim StatusPayer ContractsHome Infusion BillingSpecialty Pharmacy BillingInfusion Therapy BillingLegal ComplianceEthical Compliance
About the role
Key responsibilities & impact- Follow up on submitted insurance claims to ensure accurate and timely reimbursement
- Manage assigned payer accounts and work outstanding balances through resolution
- Investigate denied, underpaid, and unpaid claims and determine appropriate next steps
- Communicate directly with insurance payers to resolve claim issues and secure reimbursement
- Identify claims requiring correction, reconsideration, appeal, or rebilling
- Review payer contracts, coverage requirements, and reimbursement methodologies
- Collaborate with billing, pharmacy, and operations teams to resolve reimbursement issues
- Respond to internal and external inquiries regarding claim status
- Maintain accurate documentation of collection activity and payer follow-up
- Stay current on billing regulations, coding guidelines, and payer policy changes
- Utilize clearinghouses and billing systems to support collections workflows
- Assist with reporting, data entry, and additional revenue-cycle responsibilities as needed
- Maintain accuracy, professionalism, and consistent follow-through across assigned accounts
Requirements
What you’ll need- High school diploma or GED
- Minimum of 3 years of medical collections or related revenue-cycle experience
- Experience communicating with insurance payers and/or resolving outstanding claims
- Experience providing customer service to internal and external stakeholders
- Basic proficiency with Microsoft Office, including Word, Excel, and PowerPoint
- Strong analytical and problem-solving skills
- Persistence and confidence when following up with insurance payers
- Excellent attention to detail and follow-through
- Customer-service mindset balanced with financial accountability
- Ability to work effectively in a fast-paced, metrics-driven environment
- Strong written and verbal communication skills
- Ownership of assigned accounts and drive to see claims through to resolution
- Preferred: 5+ years of medical collections experience
- Preferred: Previous home infusion, specialty pharmacy, or infusion therapy billing/collections experience
- Preferred: Experience working with insurance denials, underpayments, appeals, and payer follow-up
- Preferred: Experience using healthcare billing platforms, clearinghouses, or revenue-cycle systems
- Participate annually in required legal and ethical compliance training
- Act in compliance with LUX Infusion’s legal, ethical, and compliance policies
- Adhere to standards and procedures in the LUX Infusion Compliance Manual
- Ability to prioritize competing demands and manage multiple tasks effectively
Benefits
Comp & perks- Purpose-driven work that directly supports patient access to care
- Patient-first, clinician-led culture
- Strong collaboration across revenue cycle, pharmacy, clinical, and operations teams
- Consistent Monday–Friday schedule
- Clear expectations and opportunities for professional growth
- Potential hybrid eligibility after six months based on performance and business needs