Reimbursement Specialist

Job Description Collections Specialist (Chicago, IL; Malvern, PA) – a fast‑paced revenue cycle role focused on resolving complex insurance claims, ensuring timely reimbursements and directly impacting financial performance and operational success. Your Role Manage denied and rejected insurance claims by researching root causes, correcting claim issues, and following up with payers to secure timely reimbursement. Review EOBs, payment variances, aging reports, and negative balances to ensure accurate claim processing. Work directly with insurance payers to resolve denials, authorization issues, filing errors, and reimbursement discrepancies. Escalate recurring payer trends and recommend process improvements or solutions to leadership. Verify patient eligibility and benefits, including qualifying diagnoses, prior testing, and authorization requirements. Interpret insurance benefits and claim outcomes to support accurate billing and reimbursement. Utilize Excel, dashboards, and daily/weekly worklists to track claims activity, monitor productivity, and identify reimbursement trends. Maintain compliance with internal processes, reimbursement standards, and quality expectations. Support team collaboration by assisting with payer resolution efforts across accounts and ensuring timely follow‑up on insurance correspondence and outstanding claims. You're The Right Fit If 2+ years of experience in Accounts Receivable Management, Reimbursement, Collections, or Denial Management, with hands‑on experience resolving denied and rejected insurance claims and working directly with payers. Strong denial‑management and claims‑troubleshooting abilities. Knowledge of insurance payers, including Medicare, Medicaid, Blue Cross Blue Shield and commercial plans. Proficiency in Excel, dashboards, and analyzing payer trends/worklists. Ability to verify insurance benefits and interpret EOBs (Explanation of Benefits). Strong computer skills with the ability to navigate multiple systems efficiently. Bachelor’s degree, high school diploma or GED, or vocational training in finance, accounting, business administration, economics, or a related field. Capable of meeting the required physical, cognitive, and environmental job demands with or without accommodation. Analytical, detail‑oriented, and a strong problem‑solver with excellent communication skills. Thrives working independently in a fast‑paced environment while maintaining a collaborative, adaptable, team‑focused mindset. How We Work Together We believe that we are better together than apart. This office‑based role requires full‑time presence in the company’s facilities, with in‑person work at least 3 days per week. Pay & Benefits The pay range for this position in Chicago, IL and Malvern, PA is $26.00 to $41.00 per hour. The actual base pay offered may vary within the posted range depending on job‑related knowledge, skills, experience, business needs, geographic location, and internal equity. Additional compensation, such as an annual incentive bonus, sales commission, or long‑term incentives, may be offered. Employees are eligible to participate in our comprehensive benefits program, which includes a generous PTO, 401(k) (up to 7% match), HSA (with company contribution), stock purchase plan, education reimbursement, and more. Additional Information US work authorization is a precondition of employment. The company will not consider candidates who require sponsorship for a work‑authorized visa, now or in the future. Relocation benefits will not be provided for this position. Candidates must reside in or be within commuting distance to Chicago, IL or Malvern, PA. Philips is an Equal Employment and Opportunity Employer, including Disability/Vets, and maintains a drug‑free workplace. #J-18808-Ljbffr