Medical Biller - Remote - PST or MST Only

Option Care Health•Phoenix, AZ

1d•Remote

About The Position

The RCM / Collections Specialist / Medical Biller is responsible for timely, accurate invoicing to payers for services and products provided, evaluating and correctly applying payments to patient accounts, and following up with responsible parties to ensure timely and accurate payment. The role also assists with billing and collection training and completes second-level appeals to payers. Applicants must currently reside in the Mountain or Pacific Time Zone. The position requires understanding payer contract terms and fee schedules, verifying authorization and supporting documentation, and ensuring billed services and products were properly ordered and provided. It also involves processing secondary bills and patient invoices, identifying overpayments or duplicate payments, transferring payments between offices, and pursuing unpaid or denied claims. The specialist must follow company policies, contract terms, fee schedules, and HIPAA guidelines to protect patient and business confidentiality.

Requirements

High school diploma or equivalent.
0–6 months of previous infusion reimbursement or intake/admissions experience.
Basic Microsoft Excel skills, including opening and editing workbooks, formatting cells, using copy and paste, saving, inserting rows or columns, worksheet formatting, spell check, and printing.
Basic Microsoft Word skills, including editing and formatting documents, using find and replace, spell check, track changes, and printing.
Must currently reside in the Mountain or Pacific Time Zone.

Responsibilities

Submit timely and accurate invoices to payers for products and services provided.
Understand contract terms and fee schedules for the contracts being billed.
Determine correct quantities and prices for billed drugs.
Verify that services and products are authorized and that required documentation is on file.
Ensure invoices are for services and products properly ordered and confirmed as provided.
Evaluate payments for correctness and accurately apply them to patient accounts according to fee schedules.
Mail secondary bills and patient invoices within 48 hours of receiving payment.
Notify the Reimbursement Manager about overpayments or duplicate payments for the same service.
Transfer payments belonging to other offices within 48 hours of receipt.
Follow up on submitted invoices to promote prompt payment, including confirming claims were received and are being processed.
Send letters to patients or responsible parties when insurance carriers fail to pay within a reasonable time frame.
Generate and mail statements and collection letters.
Follow up on all denials within 48 hours of receipt.
Comply with company policies, contract terms, fee schedules, and HIPAA guidelines.
Assist with billing and collection training and complete second-level payer appeals.