Collection Specialist- Infusion Pharmacy / Remote

Responsibilities

• 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

Qualifications

• A 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