Experienced Workers Comp Collection Specialist

This is a 100% remote opportunity; however, please only apply if you have 3 to 5 years of medical insurance collection experience. Workers Comp collection experience preferred.

About the role

AIS Healthcare is the leading provider of Targeted Drug Delivery (TDD) and Infusion Care. With our diverse culture and values around Innovation, Stewardship, and Unity, we are committed to advancing quality and improving lives. We are dedicated to enhancing the entire care experience through quality products and services.

The Accounts Receivable (AR) Collection role is a full-time position responsible for collection processes for TDD services, including contract analysis, reimbursement, denial management, appeals, and resolving billing-related issues with insurance companies or other responsible parties for services rendered.

Responsibilities

• Recognize patients’ rights and responsibilities and support them in the performance of job duties while respecting their rights to privacy and confidentiality.
• Follow up on invoices submitted to ensure prompt and timely payment and escalate issues as necessary.
• Evaluate payments/denials received for correctness and ensure they are applied accordingly.
• Identify bad debt write-offs and A/R adjustments, and initiate write-offs and adjustments in accordance with policies and procedures.
• Identify any overpayments and/or duplicate payments, investigate, and resolve accordingly.
• Process refund requests in accordance with policies and procedures.
• Maintain contact with other departments to obtain patient or insurance information needed for claim payment.
• Understand all procedures within regulatory mandates and ensure collection activities comply with Federal, State, and payer regulations, guidelines, and requirements.
• Make calls to troubleshoot payment discrepancies and establish resolution.
• Document, in detail, phone calls, phone numbers, persons spoken to, and call details on a consistent basis.
• Consistently look for areas to maximize claim reimbursement.
• Resolve issues that created a denial within 5 days of receipt of denial.
• Maintain strictest confidentiality and adhere to all HIPAA guidelines/regulations.
• Maintain understanding of NDC (National Drug Code) numbers, metric quantities, and knowledge of infusion supplies.
• Maintain a broad range of knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes.
• Share knowledge gained with other staff members and work as a team member.
• Interact with others in a positive, respectful, and considerate manner.
• Perform other job-related duties as assigned.

Requirements

• High school diploma or general education degree (GED) equivalent is required.
• 3-5 years of healthcare industry experience.
• 3-5 years of medical billing and collections experience.
• Home Infusion or Intrathecal Pain Management experience preferred.

Qualifications

• Ability to recognize, evaluate, and exercise good judgment in solving complex situations and advising in accordance with laws and regulations.
• Excellent verbal and written communication and relationship-building skills with an ability to prioritize, negotiate, and work with a variety of internal and external stakeholders.
• Strong work ethic with personal qualities of integrity and credibility.
• Self-directed, detail-oriented, conscientious, organized, and able to follow through.
• Ability to deal in an organized manner with problems involving multiple variables within the scope of the position.
• Tolerant of frequent interruptions and distractions from staff and other internal support teams.
• Proficient in Microsoft Office, including Outlook, Word, and Excel.

Benefits

• Health, vision, and dental insurance.
• Long-term disability insurance.
• Life insurance.
• Vacation package.
• 401K plan with a generous employer contribution.

Additionally, we offer a 100% work-from-home model.