Collections Specialist I

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Collections Specialist I Full Time Clerical Remote - Work From Home Salary Range: $24.00 To $26.00 Hourly We're hiring nationwide! This position is open to candidates across the United States, excluding California, New York, and Colorado. Sentido Health is a boutique home health solutions company founded on a deeply personal mission — to support medically complex patients and their families with the heartfelt care we'd give our own. We offer the product selection and clinical resources of large national organizations, delivered with the individualized approach only a boutique provider can. We consider our patients family, and our team is built on the belief that every person deserves more than a delivery — they deserve a partner. The Opportunity We're not just offering a job — we're offering a meaningful career in a mission-driven environment. Be the behind-the-scenes hero making a difference. As a Collections Specialist, you'll help ensure patient accounts are on track by managing insurance follow-ups, reprocessing claims, and resolving denials — all while maximizing reimbursements. Essential to this position is the ability to manage all insurance follow-up for maximum insurance reimbursement, including outbound and inbound insurance carrier calls, reprocessing claims, drafting appeals, working denials, and resolving unpaid claims. If you're detail-oriented and love solving challenges, we want you on our team. Join a company where collaboration and care aren't just for patients — they're at the heart of everything we do. What You'll Do Follow up on outstanding claims and unpaid accounts, proactively identifying and resolving billing and collection issues Resolve claim denials and discrepancies by conducting thorough research, contacting insurance companies, and appealing denials when necessary Apply a thorough understanding and interpretation of Explanation of Benefits (EOBs) and remittance advice, including when and how to ensure that correct and appropriate payment has been received Recognize when additional assistance is needed to resolve insurance balances, and elevate appropriately and timely through defined communication and escalation channels Notify your Supervisor of claim edits that could be reduced or eliminated through system modifications and/or communication and feedback to the department or other areas Follow established Collections processes and procedures Calculate patient responsibility, interpret explanation of benefit message codes, and identify payment discrepancies by contacting the insurance carrier and determining if rebilling is necessary Record pertinent data on collection efforts and customer financial status in the database Collect clinical information requested by insurance companies Monitor and maintain assigned accounts, account adjustments, small balance write-offs, customer reconciliations, and process patient and insurance refunds Ensure compliance with all corporate policies and procedures, third party payer requirements, and governmental laws and regulations Provide regular communication with the team and management regarding collections Communicate effectively over the phone and through written correspondence to explain why a balance is outstanding, denied, and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements Communicate all payment issues on accounts to the Collections Supervisor so timely communication can be made to the families Analyze and interpret documents, contracts, notes, and other correspondence Manage multiple tasks, prioritizing your workload in an efficient manner Take on special projects as assigned How Success Is Measured All appeals, reconsiderations, and/or corrected claims are submitted within appropriate time limits set by payors All incoming mail is worked within 48 hours of receipt Denials or short pays identified by payment posting are worked within 1 week of receipt The 60–90 day aging report for assigned payors is worked each month to ensure all claims are on file and no deadlines are missed Top 10 accounts for assigned payors are worked monthly, with results reported to the Collections Supervisor by the 2nd business day of the following month What You Bring Experience recognizing the needs and concerns of individuals The ability to communicate effectively, both orally and in writing The ability to follow verbal and written instruction Professional telephone and email etiquette The ability to work in a fast-paced, self-directed environment A detail-oriented approach paired with excellent time management skills Decision-making, problem resolution, and creative thinking skills The ability to respond well to multitasking while providing exceptional customer service, support, and responsiveness Education & Experience Experience with Medicaid, Medicare, and/or Commercial Insurance Collections in Texas is highly preferred DME Collections experience highly preferred Brightree experience is a plus Boutique culture: National resources with a personal touch — you're not a number here Mission you’ll feel: Founded by family, for families – the work is genuinely meaningful Comprehensive benefits: Medical, dental, vision, life, accidental, short-term disability, flexible savings account, GAP, and telehealth PTO: 80 to 160 based on tenure 401(k) with matching: 100% match up to 4%, partial match up to 6% Wellness perk: Free gym membership or a $25 monthly stipend if participating gym is unavailable in your area Growth opportunities: Internal development and advancement pathways Competitive pay: $24–$26 per hour, based on experience — because we value your expertise Quarterly bonuses: Earn extra based on our company's profitability metrics This is a full-time, fully remote position. Days and hours of work are Monday through Friday, 8:00 a.m. to 5:00 p.m., or other agreed upon schedule. This role requires the ability to lift and carry up to 10 pounds. No travel is required. Ready to Make an Impact? Join a team where your work directly improves the lives of medically fragile patients and the families who love them. Sentido Health participates in the E-Verify program to confirm the employment eligibility of all newly hired employees. Sentido Health is an Equal Opportunity Employer. We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type based on race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. Reasonable accommodation may be provided to qualified individuals with disabilities to perform essential job functions. #J-18808-Ljbffr Sentido Health