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Collection Specialist – Infusion Pharmacy
Job Description:
- Ensures daily accomplishments work towards company goals for cash collections by accurately working all assigned AR over 60 days if working aging and all denied claims within 7 days of posted denial if working denials
- Understands and adheres to state and federal regulations and company policies regarding compliance, integrity, patient privacy and ethical billing and collection practices
- Research outstanding balances and takes necessary collection action to resolve in a timely manner; recommends necessary demographic changes to patient accounts to ensure future collections
- Research assigned correspondence; takes necessary action to resolve requested information in a timely manner; establishes appropriate follow up
- Resubmits accurate and timely claims in formats including, but not limited to, CMS-1500 and electronic 837
- Utilizes most efficient resources to secure timely payment of open claims or invoices, giving priority to electronic solutions
- Negotiates payment plans with patients in accordance with company collection policies
- Identifies patterns and trends of denials, short-payment or non-payment and brings them to the attention of appropriate supervisory personnel
- Reviews insurance remittance advices for accuracy. Identifies billing errors, short-payments, overpayments and unpaid claims and resolves accordingly, communicating any needed system changes
- Reviews residual account balances after payments are applied and generates necessary adjustments (within eligible guidelines), overpayment notifications, refund requests and secondary billing
- Interacts with third party collection agencies
- Communicates consistently and professionally with other Amerita employees
- Works within specified deadlines and stressful situations
- Works overtime when necessary to meet department goals and objectives
Requirements:
- High School Diploma/GED or equivalent required; some college a plus
- A minimum of one (1) year experience in medical collections with a working knowledge of managed care, commercial insurance, Medicare and Medicaid reimbursement; home infusion experience a plus
- Working knowledge of automated billing systems; experience with CPR+ preferred
- Working knowledge and application of metric measurements, basic accounting practices, ICD-9, CPT and HCPCS coding
- Solid Microsoft Office skills required, including Word, Excel and Outlook
- Ability to type 40 wpm and proficiency with 10-key calculator
- Ability to independently obtain and interpret information
- Strong verbal and written communication skills
Benefits:
- DailyPay
- Flexible Schedules
- Competitive Pay with Shift Differentials
- Health, Dental, Vision, and Life Insurance
- Company-Paid Disability Insurance
- Tuition Assistance & Reimbursement
- Employee Discount Program
- 401k Plan
- Paid Time Off
- Non-Retail, Closed-Door Environment