[Hiring] RCM / Collections Specialist / Medical Biller @Option Care Health

Role Description

Responsible for the timely, accurate submission of invoices to responsible payer, of any type, for all services and products provided. Evaluates payments received and application to the patient account. Follows-up with responsible parties to ensure the receipt of timely, accurate payments. Assists with Billing and Collection Training and completes "second level" appeals to payers.

• Submits timely, accurate invoices to payer for products and services provided.
• Understands the terms and fee schedule for all contracts for which invoices are submitted.
• Correctly determines quantities and prices for drugs billed.
• Verifies that the services and products are correctly authorized and that required documentation is on file.
• Ensures that invoices are submitted for services and products that are properly ordered and confirmed as provided.
• Evaluates payments received for correctness and applies payments accurately to the system.
• Verifies that payments received are correct according to the fee schedule.
• Applies the payment correctly to the patient account.
• Ensures that secondary bills and patient invoices are mailed within 48 hours of receipt of payment.
• Notifies the Reimbursement Manager if there are overpayments and/or duplicate payments for the same service.
• Transfers payments belonging to other offices within 48 hours of receipt.
• Follows up on invoices submitted to ensure prompt and timely payment.
• Calls to verify that claims submitted were received and are in processing.
• Sends letters to the patient or responsible party when their insurance carrier fails to make payment in a reasonable time frame.
• Generates and mails statements and collections letters.
• Follows-up on all denials within 48 hours of receipt.
• Ensures compliance with policies and guidelines outlined in the contract terms and fee schedule.
• Follows HIPAA guidelines when accessing and sharing patient information to maintain patient and business confidentiality.

Qualifications

• High School Diploma or equivalent.
• 0 – 6 months previous Infusion Reimbursement or Intake/Admissions experience.

Requirements

• Basic level skill in Microsoft Excel (for example: opening a workbook, inserting a row, selecting font style and size, formatting cells as currency, using copy, paste and save functions, aligning text, selecting cells, renaming a worksheet, inserting a column, selecting a chart style, inserting a worksheet, setting margins, selecting page orientation, using spell check and/or printing worksheets).
• Basic level skill in Microsoft Word (for example: opening a document, cutting, pasting and aligning text, selecting font type and size, changing margins and column width, sorting, inserting bullets, pictures and dates, using find and replace, undo, spell check, track changes, review pane and/or print functions).

Benefits

• Medical, Dental, & Vision Insurance
• Paid Time off
• Bonding Time Off
• 401K Retirement Savings Plan with Company Match
• HSA Company Match
• Flexible Spending Accounts
• Tuition Reimbursement
• myFlexPay
• Family Support
• Mental Health Services
• Company Paid Life Insurance
• Award/Recognition Programs