Medical Collections Specialist

TEKsystems • Elk Grove Village, IL • 8h ago

Position Summary:

The Specialty Pharmacy Medical Collector is responsible for managing the collection of outstanding medical claims and balances from commercial, Medicare, and Medicaid payers. This role requires deep familiarity with specialty pharmacy billing practices, payer portals, and denial resolution processes. The collector will work closely with internal teams and external payers to ensure timely and accurate reimbursement for high-cost therapies.

Key Responsibilities:

Manage a daily workload of 30-35 accounts, focusing on follow-up, denial resolution, and payment posting.

Investigate and resolve claim denials, recoupments, and offsets by analyzing payer responses and initiating appeals or disputes as needed.

Navigate payer portals (e.g., Availity) to verify claim status, submit documentation, and track appeals.

Collaborate with billing, benefits verification, and patient services teams to ensure claims are clean and complete.

Understand and differentiate between pharmacy and medical benefits to route claims appropriately.

Review and interpret payer medical policies to ensure compliance and pre-authorization alignment.

Maintain accurate documentation of all collection activities in systems such as CareTend or FastTrack.

Communicate professionally with payers and internal stakeholders to resolve issues and escalate complex cases when necessary.

Qualifications

3+ years of specialty pharmacy medical collections experience

3+ years of experience with pharmacy benefits (PBM's) AND major medical experience

Well versed in Medicare part D and B, Medicaid and commercial plans

Familiarity with Availity and other payer portals; Waystar experience is a plus.

High School diploma

Commutable to Elk Grove Village, IL

Pay and Benefits

The pay range for this position is $22.00 - $26.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a hybrid position in Elk Grove Village,IL.

Application Deadline

This position is anticipated to close on Jun 19, 2025.

About TEKsystems and TEKsystems Global Services

We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

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