Collections Representative

About the role

The Collections Representative is responsible for managing and resolving outstanding account balances through timely and effective follow-up with payers and internal departments. This role ensures accurate account research, prompt collection activity, and proper documentation while maintaining compliance with company policies, payer guidelines, and regulatory standards. The Collections Representative supports overall revenue cycle efficiency by reducing aged receivables, addressing claim issues, and securing timely reimbursement.

Key responsibilities

• Conduct follow-up with insurance carriers to resolve outstanding balances.
• Verify claim status, resolve denials, and secure timely reimbursement through calls, portals, and documentation review.
• Research account discrepancies, underpayments, and missing remittances.
• Coordinate with internal RCM teams to resolve claim issues and escalate high-priority accounts when needed.
• Document all collection activities clearly and accurately in the billing system.
• Ensure compliance with payer rules, internal policies, and HIPAA guidelines.
• Identify trends and root cause of payor behaviors.
• Perform related tasks and support team goals as assigned.

About you

• High school diploma or equivalent; Associate degree preferred.
• 1–2 years of experience in medical collections, billing, or revenue cycle operations.
• Ability to interpret EOBs/ERAs and navigate billing software.
• Strong communication skills, including outbound calls to payers.
• Basic proficiency with Microsoft Office and familiarity with coding and payer guidelines.
• Strong attention to detail, problem-solving skills, and ability to manage high-volume workloads.
• Excellent interpersonal skills.
• Basic Excel, Word and Outlook experience required.
• Must be able to work a night shift from minimum 8:00 pm to 8:00 am Philippine Standard Time.