Medical Biller - Remote - PST or MST Only

Option Care Health•Fort Collins, CO

6d•Remote

About The Position

The RCM / Collections Specialist / Medical Biller is responsible for timely and accurate invoicing to payers for services and products provided, evaluating and applying payments to patient accounts, and following up with responsible parties to secure timely, 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 contracts and fee schedules, determining drug quantities and prices, verifying authorizations and supporting documentation, and confirming services and products were ordered and provided before invoicing. It also involves payment review and account application, sending secondary bills and patient invoices, escalating overpayments or duplicate payments, and transferring payments to the appropriate offices. The specialist follows up on submitted invoices, denials, and outstanding payments through calls, letters, statements, and collection correspondence. The role must follow contract terms, fee schedules, company policies, and HIPAA guidelines to protect patient and business confidentiality. A high school diploma or equivalent and 0–6 months of previous infusion reimbursement or intake/admissions experience are listed. Basic Microsoft Excel and Word skills are also required.

Requirements

High school diploma or equivalent.
0–6 months of previous infusion reimbursement or intake/admissions experience.
Basic Microsoft Excel skills, including workbook and worksheet operations, formatting, copying and pasting, chart selection, page setup, spell check, and printing.
Basic Microsoft Word skills, including document editing and formatting, sorting, inserting bullets and images, find and replace, track changes, spell check, and printing.
Must currently reside in the Mountain or Pacific Time Zone.

Responsibilities

Submit timely, accurate invoices to payers for products and services provided.
Understand contract terms and fee schedules, determine correct drug quantities and prices, verify authorizations and documentation, and confirm products and services were ordered and provided.
Evaluate payments for correctness and accurately apply them to patient accounts.
Ensure secondary bills and patient invoices are mailed 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 ensure prompt and timely payment, including calling to confirm claims were received and are being processed.
Send letters to patients or responsible parties when insurance carriers do not pay within a reasonable time frame.
Generate and mail statements and collection letters.
Follow up on all denials within 48 hours of receipt.
Ensure compliance with contract terms, fee schedules, policies, and guidelines.
Follow HIPAA guidelines when accessing and sharing patient information to protect patient and business confidentiality.
Assist with billing and collection training and complete second-level appeals to payers.