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Collection Specialist – Infusion Pharmacy
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Collection Specialist – Infusion Pharmacy
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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