AllergyMoms LLC · 1 day ago
Collections Specialist - Remote
United States
Full-time
Remote
Entry, Mid Level
2+ years expAllergyMoms LLC is a premier pharmacy franchise business committed to improving the lives of patients and healthcare professionals. They are seeking a Collections Specialist to perform duties related to collecting Home Infusion claims, focusing on accuracy and timeliness to reduce denial rates and improve collection rates.
Health Wellness & Fitness
Responsibilities
Review claims with outstanding balances and identifies actions to successfully collect revenues
Follow up with insurers and patients to collect outstanding balances in an environment focused on building enduring customer and business relationships
Utilize Payer Portals via the internet for claim disposition
Review documents received including Explanations of Benefits (EOBs), Remittance Advices (RAs), and other documents indicating denials or claims acceptance
Identify reasons for denials, take required corrective action, and take ownership of claims through to timely, successful collection
Analyze denials, identify trends, and recommend process improvement opportunities that will result in DSO reduction, superior collection rate, intervals reduced bad debt and simplified processes that are responsive to the requirements of specific payers
Identify payor requirements for submittal of appeals for denied claims
Verify insurance information with patients, order medical records, review original claim coding, compile other validating documentation required, and submit appeals in keeping with payor requirements and VCI processes
Communicate effectively with franchise partners and other VCI departments regarding the status of collections
Resolve payer issues/concerns timely
Document case activity, communications, and correspondence in the computer system to ensure completeness and accuracy of account activity and actions are taken to resolve outstanding claims issues
Schedule follow-ups in required intervals
Investigate and verify benefits for pharmacy and medical third-party claims
Communicate billing problems found during collection process as to avoid the same issues in the future
Communicate financial obligation information with patients so that they have a clear understanding of all costs of therapy prior to starting service
Contribute medical billing expertise to the design of training and knowledge transfer programs, materials, policies, and procedures to improve the efficiency and effectiveness of the RCM team
Assist with the processing of online adjudication of collection issues and nurse billing as assigned
Perform other related duties as assigned
Qualification
Required
Excellent communications skills; listening, speaking, understanding, and writing English while influencing patients, caregivers, payer representatives, and others, answering questions, and advancing reimbursement and collection efforts
Proven understanding of processes, systems, and techniques to ensure successful billing and collection working with all payer types
Proven ability to identify gaps and problems from the review of documentation, determine lasting solutions, make effective decisions, and take necessary corrective action
Strong organization skills with the ability to track and maintain clear, complete records of activities, cases, and related documentation
Proven knowledge and skill in the utilization of MS Office suite of software and pharmacy applications
Ability to complete job duties in a designated workspace outside the dedicated RCM location
Disciplined work ethic with ability to work remotely with minimum direct supervision, to effectively meet production and collection targets
2-5 years home infusion billing and/or collections experience required
High School Diploma and additional specialized training in intake, pharmacy/medical billing, and/or collections
Sitting: Prolonged periods of sitting are typical, often for the majority of the workday
Keyboarding: Frequent use of a keyboard for typing and data entry
Reaching: Occasionally reaching for items such as files, documents, or office supplies
Fine Motor Skills: Precise movements of the fingers and hands for tasks like typing, using a mouse, and handling paperwork
Visual Acuity: Good vision for reading documents, computer screens, and other detailed work
Preferred
Previous remote work environment is a plus but not required
Detailed oriented with post-billing and post-payment investigative experience preferred
Benefits
Comprehensive medical, dental, and vision plans, plus flexible spending, and health savings accounts.
Paid time off, personal days, and company-paid holidays.
Paid Paternal Leave.
Volunteerism Days off.
Income protection programs include company-sponsored basic life insurance and long-term disability insurance, as well as employee-paid voluntary life, accident, critical illness, and short-term disability insurance.
401(k) matching and tuition reimbursement.
Employee assistance programs include mental health, financial and legal.
Rewards programs offered by our medical carrier.
Professional development and growth opportunities.
Employee Referral Program.
Company
AllergyMoms LLC
The AllergyMoms website provides support for parents of kids with food allergies.
0-1 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase