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AIS Healthcare · 1 day ago

Experienced BCBS Insurance Collections Specialist

United States

Full-time

Remote

Mid Level

3+ years exp

AIS Healthcare is the leading provider of Targeted Drug Delivery (TDD) and Infusion Care. They are looking for experienced and motivated Accounts Receivable Collection experts to join their dynamic team, responsible for collection processes for TDD services including contract analysis, reimbursement, denial management, and resolving billing-related issues with insurance companies.

Health CarePharmaceutical

Responsibilities

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

Qualification

Medical billing experienceCollections experienceHealthcare industry experienceHome Infusion experienceIntrathecal Pain ManagementMicrosoft Office proficiencyVerbal communication skillsWritten communication skillsRelationship building skillsDetail orientedWork ethic

Required

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

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