Medical AR Collections Specialist

Onco360 Pharmacy is looking for a Medical AR Collections Specialist for our Pharmacy located in Louisville, KY.

Remote work may be available.

Work Hours: Monday-Friday - Daytime Hours 8:30am-5pm EST.

• Starting salary at $23/hr** We also offer quarterly incentive bonuses.
  
  

We offer a variety of benefits including:

• Medical, Dental & Vision insurance
• 401k with a match
• Paid Time Off and Paid Holidays
• Tuition Reimbursement
• Paid Volunteer Day
• Floating Holiday
• Referral Incentive
• Paid Life, and short & long-term disability insurance
  
  

Medical AR Collections Specialist Summary:

The Medical AR Collections role will be responsible for medical billing of company specific IV and oral therapies on CPT platform. Daily functions require working knowledge of HCPC coding, ICD-10, JCodes, and CPT codes as well as experience interacting with Medicare, Medicaid, and Commercial insurances. Individual must be able to perform the essential functions of this position as listed below.

Medical AR Collections Specialist Major Responsibilities:

• Follow up on all unpaid claims and aging A/R items, working directly with the insurance company, healthcare provider, and patient to get a claim processed and paid
• Research all denials and complete claim corrections, resubmissions, and adjustments accurately and timely as necessary. Must have a high ability to deal with complex claim issues.
• Verify that payments received are correct and according to payer fee schedules and company contractual agreements. Proficient at reading and interpreting EOBs and all forms of payer/insurance correspondence for both Pharmacy and Medical claims.
• Assign appropriate status to claims in Pharmacy processing system to ensure appropriate handling by appropriate RCM team personnel; make necessary demographic changes to reduce rejections of submitted electronic and paper claims.
• Ensure daily activities work towards company goals for cash collections and Accounts Receivable under 90 days, Ready to Bill (pending revenue) under 14 days, weekly and month end close processes and other departmental goals as outlined.
• Efficiently uses company billing software platform, including maintaining accurate and detailed patient and billing notes to assist in documentation and collection of claims.
• Tracking Unapplied Cash to ensure timely and accurate relief of aged accounts. Coordinate with cash team to ensure pending payment postings are accounted for properly and resolved timely.
• Must be able to communicate succinctly and professionally both verbally and through written correspondence with Physician offices, nurses, insurance companies and patients as needed.
• Exhibits a positive, courteous, respectful and helpful attitude towards patients, team members, payers, and management.
• Work within specified deadlines and open to overtime when necessary to meet department goals and objectives.
• Performs other tasks as assigned by Manager, Director and/or Senior Leadership.
• Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
  
  

Education/Learning Experience

• Required: High School Diploma or GED.
• Required: 3 years experience Medical, HCPCS billing and collections
• Desired: Specialty Pharmacy Infusion Billing
  
  

Work Experience

• Required: 2-3 years Healthcare Accounts Receivable
• Desired: 3 years
  
  

Skills/Knowledge

• Required: Medicare HCPCS knowledge
• Desired: Specialty Pharmacy knowledge
  
  

Behavior Competencies

• Required: Deadline Oriented, Time Management, Prioritization Skills
  
  

Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers.

A career with us is more than just a job. It's an opportunity to connect and care for our patients, providers, communities and each other. We attract extraordinary people who have a strong desire to live our mission - to better the lives of those battling cancer and rare diseases. Compassion is more important than numbers. We value teamwork, respect, integrity, and passion.

We succeed when you do, and our company and management team work hard to foster an environment that provides you with opportunities for both professional and personal growth.