At Amber Specialty Pharmacy, our commitment to patient care is unmatched. Enjoy fulfillment in a career where you have the opportunity to make a positive impact on patients with complex and chronic conditions. Medical/Pharmacy collections Monday -Friday Hourly Rate: $19.27 to $22.48 depending on experienceAmber Specialty Pharmacy Job Title: Collection Specialist Department: Claims/Billing FLSA: Non-ExemptGeneral Functions: The Collection Specialist ensures accurate insurance information is received and stored. They gather all information required to bill electronic NCPDP claims in the appropriate order in the event of multiple payers and review statements to determine accuracy. Collections Specialists help navigate financial assistance programs to help patients gain financial support. Communicating with coordinators and co-workers regarding insurance verification and promoting exceptional customer service and professionalism with the community is key in this position.Reporting Relations: Reports to : Lead Collection Specialist Direct Reports: NonePrimary Duties and Responsibilities: Consults with patients to resolve all types of payer and coverage issuesContacts the patient, when necessary, to gather insurance and billing information or notify of a delay in processingConducts a benefits investigation, updates patient accounts, prescriptions, etc.Collects on outstanding patient balancesProcesses adjudication rejections, insurance terminations, and insurance changesHandles patient benefit statement questions to a conclusionResearches and reviews patient inquiries on account balancesConducts welcome calls for new transplant patientsKnows Amber HIPAA policies and maintains patient confidentiality at all times. Works as a team member with all other departments to verify benefitsWorking knowledge of all necessary computer software to perform job dutiesBills claims via electronic NCPDP clearinghouse and/or MedicalWorks claims in the clearinghouse to ensure our payers receive themResponsible for aiding in accounts receivable by billing claims correctly and getting them to our payers on timeWorks with team to achieve company AR goalsUnderstanding of payer contracts and how claims should be submitted to each payerFollows up on claims to ensure receipt by the payerBills secondary claims and ensures timely filing limits are not exceededEnsures that payer guidelines are followed for processing claimsFollows up with Pharmacy and Medical Billing Specialists to make sure all changes are addressedThis is an office-based positionProfessional Competencies: Proficient with MS Excel, Word, and Outlook StrongOral, written, organizational, and interpersonal skillsDemonstrated ability to meet tight deadlinesAbility to work in a team and with all levels of internal management and staff, as well as outside clients and vendorsEducational and Experience Requirements: High school diploma or equivalentWorking knowledge of the healthcare industryHIPAA trained and /or the ability to work with and protect highly confidential patient and employee informationOne (1) year of experience billing electronic insurance claims, including; Medicaid, Medicare, and Commercial insurance via NCPDP clearinghouse. Medical billing experience preferredExperience working with clearinghouses for claim adjudicationSix (6) months to one-year phone-based customer servicePhysical Requirements: Must be able to remain in a stationary position up to 90% of the timeThe person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc., and traverse conferences, meetings, and remote eventsConstantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printerThe ability to communicate information and ideas so others will understand. Must be able to exchange accurate information in these situationsThe ability to observe details at close range (within a few feet of the observer)Working Conditions: Normal office environment.Equipment Used to Perform the Job: Computers, keyboards, mouse, monitors, fax, and/or headsets for phone work. Software specific to the position, including but not limited to Microsoft Outlook and Skype. Must lift and traverse the area to move paper and supplies to use the equipment.Contacts : Frequently interact with co-workers, intradepartmental staff of the Company, managers, leaders, Vendors, and customers.Confidentiality: The position Interactions with medical personnel, patients and accesses proprietary and medical (HIPAA) information in various interactions and matters.Apply now and join our mission to provide exceptional patient care!#J-18808-Ljbffr

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