Medical Biller and Collections

BioMatrix Specialty Pharmacy•Clinton, NY

60d•Hybrid

About The Position

This position is available with Upstate HomeCare, a BioMatrix company. 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. Schedule: Monday Through Friday From 8:30am Eastern Standard Time To 5pm Eastern Standard Time Work schedule is subject to change based on business needs. Location: Upon successful completion of on-site training, it is anticipated that an incumbent in this role will work in a hybrid capacity from one of the noted locations on Mondays, Wednesdays, & Fridays while working from home on Tuesdays & Thursdays. Work location is subject to change based on business needs. Job Description: Directly provides efficient management and collections of patient/customer accounts aligning with prevailing company, state, federal and payer standards.

Requirements

High school diploma or GED required
Minimum of two (2) years of billing experience required
Demonstrates strong computer literacy and aptitude as evidenced by proficiency and/or training with applicable software systems
Knowledge of NYS Medicaid, Medicare Part B, and third-party payers
Good written and verbal communication
Prioritization skills
Alignment to given instructions
Independent worker

Nice To Haves

Associate's degree in Health Care Service, Medical Sales, or a related field preferred
Prior billing experience with home medical equipment provider preferred

Responsibilities

Providing excellent customer service by:
Being courteous and prompt in response to customer/staff inquiries
Explaining financial responsibilities with customer and/or caregiver
Providing accurate information to customer and/or caregiver and/or staff
Documenting customer account issues/concerns (when applicable) and forwarding to the appropriate manager
Improves departmental/company productivity and efficiency by:
Making corrections and updating patient account files
Accurately submitting claims to correct carriers on a regular schedule
Reviewing and resubmitting aged claims well in advance of time limits
Handling denials in manners most advantageous to quick resolution and payment
Working aged claims as instructed, monitoring progress weekly, negotiating payer commitments
Volunteering or initiating assistance in other activities (not listed in JD) when it is beneficial to the department/company
Minimizing claims aged beyond 90 days
Follows departmental/company policies and procedures by:
Understanding and following Confidentiality Policy
Serving as company resource on processing/reimbursement issues
Maintaining a safe, clean and organized work area
Understanding and following complaint procedures
Monitoring that appropriate signatures & justification accompany service orders
Following applicable Medicare, Medicaid regulations
Following state and insurance carrier regulations
Following regulations set forth in company contracts
Shows teamwork, initiative and accountability by:
Volunteering to assist co-workers
Staying current with industry/coverage changes
Ensuring completion of required in-services, testing and/or immunizations
Complying with applicable memo's and policy changes as issued
Presenting solutions in conjunction with problems
Exhibits exceptional work ethics by:
Not being wasteful or abusing branch/region resources (vehicles, buildings, equipment, supplies, phones, utilities, time at work and time absent from work, etc.)
Presenting fair and honest reports of expenses (travel, gas, on call, etc.)
Following through timely with commitments
Allowing others to speak without interruption
Asking clarifying questions and showing consideration of others comments
Using proper grammar, a respectful tone and language free of prejudice, harassment, profanity or ill will connotations
Answering calls within three rings and properly introducing self in a pleasant and clear voice
Returning phone messages promptly, responding calmly to angry or upset referrals/customers and avoiding personal calls (or minimizes) to allow customer access to business lines
Attempting to resolve conflict without 3rd party intervention, refraining and discouraging gossip, and portraying the company in a positive light to customers and co-workers