Lead Collections Specialist

BioMatrix Specialty Infusion Pharmacy•Overland Park, KS

6h•$28 - $28•Onsite

About The Position

BioMatrix is a nationwide, independently-owned infusion pharmacy with decades of experience supporting patients on specialty medication. Our compassionate care team helps patients navigate the often-challenging healthcare environment. We treat our patients like family and get them started on therapy quickly. We work closely with them as well as their family and their healthcare providers throughout the patient journey, staying focused on optimal clinical outcomes. At BioMatrix the heart of our Inclusion, Diversity, Equity, & Access (IDEA) philosophy is the commitment to cultivate a welcoming space where everyone’s contributions are acknowledged and celebrated. Our goal is to draw in, develop, engage, and retain talented, high-performing individuals from diverse backgrounds and viewpoints. We believe that both respecting and embracing diversity enriches the experiences and successes of our patients, employees, and partners. The Lead Collections Specialist serves in a lead capacity to functionally assist the RCM Collections Manager with the training and support of the Collections Specialists. They are responsible for claims submission follow-up for correct and timely payment to achieve the goal of low delinquent payer balances and ensuring the effective and efficient management of the assigned collections / reimbursement. This position will also monitor collections activity and develop necessary corrective action to resolve deficiencies and assist other team members with difficult accounts. Ensures all compliance, legal and regulatory requirements are met when interacting with all Internal and External customers. Ensures customer inquiries are resolved in a timely professional manner.

Requirements

5-7 years’ experience in high volume pharmacy/infusion billing and collections, preferred.
High School Diploma or equivalent
Understanding of basic medical terminology
Understanding and knowledge of revenue cycle, insurance billing and collections, Medicare, Medicaid, 3rd party payors.
Knowledge of Coding ICD-10, HCPCS, CPT, HER preferred
Understanding insurance audits, and other external actions that impact revenue
Maintains strictest confidentiality of patient information in compliance with HIPAA and state and federal regulations
Strong verbal and written communication skills to individuals and business at all different education levels
Advanced computer skills and knowledge of office software packages. MS Office (Excel, Word).
Excellent verbal, written, and communication skills.
Communication Skills
Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; Participates in meetings.
Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.
Computer Skills

Nice To Haves

CPR+ experience not required, but a bonus.

Responsibilities

Assist by providing adequate resources and training for new employees
Support team members daily with problematic accounts
Provide clear and compelling direction to team members, etc.
Collection calls and/or correspondence to payers for status of submitted claims
Review of EOB’s for correct payment, denials, zero and short pays or additional information required to process claims
Submit secondary claims, appeals for denials or short pays, appeal letters, claims review forms
Submit a “CIF” (Claim Inquiry Form) for Medicaid such as California, or other states required forms
Accountable for reducing delinquency for assigned accounts, reducing bad debt
Monitor overall company aging and payor specific trends reporting
Identifies, reports and responds to overpayment requests and recoupments
Establish and maintain effective and cooperative working relationships with payors
Enlist the efforts of sales and senior management when necessary to accelerate the collection process
Utilize billing system to manage and update claims status
Communicate and follow up with billing regarding customer accounts discrepancies and billing procedures
Weekly/Monthly reporting to direct supervisor, management as requested
Perform other assigned tasks and duties as necessary to support the Accounts Receivable Department
Ability to prioritize and handle multiple tasks and projects concurrently.
Must have scheduling flexibility and be able to work overtime.
Careful attention to detail.
Performs related duties as requested.
Participates in quality assurance activities and audits as directed.
Ability to actively communicate with all levels of staff.
Ability to maintain accurate records and prepare reports and correspondence related to the work.
Ability to maintain favorable public relations.
Become and remain proficient in all programs necessary for execution.
Will participate in legal and ethical compliance training each year.
Will consistently behave in compliance with the BioMatrix, LLC’s legal and ethical policies and procedures.
Will abide by the policies of BioMatrix, LLC as set forth in the Compliance Manual.
Will not participate in any conduct considered to be unethical or illegal.
Supports the organization's mission, vision, and values by exhibiting the following behaviors: integrity, dedication, compassion, enrichment and enthusiasm, places patients first, is all-in with stacked-hands, and is focused on relentless consistency wins.