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
  • 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
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