[Hiring] Experienced Humana Insurance Collection Specialist @AIS Healthcare

Role Description

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

AIS Healthcare is looking for experienced and motivated Accounts Receivable Collection experts to join our dynamic team! The AR Collection role is a full-time position responsible for collection processes for TDD services that includes:

• Contract analysis
• Reimbursement
• Denial management
• Appeals
• Resolving billing-related issues with insurance companies or other responsible parties for services rendered

The perfect candidate should have an in-depth knowledge of collection practices related to billing and collection activities.

Qualifications

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

Requirements

• Recognizes patients’ rights and responsibilities and supports them in the performance of job duties, respects patient’s rights to privacy and confidentiality
• Follows up on invoices submitted to ensure prompt and timely payment and escalates issues, as necessary
• Evaluates payments/denials received for correctness and ensures they are applied accordingly
• Identifies bad debt write-offs and A/R adjustments; initiates write-offs and adjustments in accordance with policies and procedures
• Identifies any overpayments and/or duplicate payments and investigates and resolves accordingly
• Processes refund requests, in accordance with policies and procedures
• Maintains contact with other departments to obtain patient or insurance information needed for claim payment
• Responsible for understanding all procedures within regulatory mandates
• Ensures that the activities of the collection operations are conducted in a manner that is consistent with overall department protocol, and are following Federal, State, and payer regulation, guidelines, and requirements
• Makes calls to troubleshoot payment discrepancies and establish resolution
• Documents, in detail, phone calls, phone number, person spoken to, and call details on a consistent basis
• Consistently looks for areas to maximize claim reimbursement
• Resolves issues that created a denial within 5 days of receipt of denial
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations
• Maintains understanding of NDC (National Drug Code) numbers, metric quantities, and knowledge of infusion supplies
• Maintains a broad range of knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes
• Shares knowledge gained with other staff members and works as a team member
• Interacts with others in a positive, respectful, and considerate manner
• Performs other job-related duties as assigned

Benefits

• Health, vision, and dental insurance
• Long term disability insurance
• Life insurance
• Vacation package
• 401K plan with a generous employer match
• 100% work from home model

Steps to Apply

To apply for this role, you must complete a Culture Index Assessment to be considered. Please note that your application will not be considered if the Assessment is not completed. Copy and paste the following link into your browser and press enter. Then, select the corresponding position for which you are applying. (Only one assessment per candidate is required.) The assessment is brief, taking less than ten minutes to complete.

portal.cultureindex.com/public/survey/general/0BFB8F0000