Revenue Cycle Management Specialist

About the position

With the nation’s largest home infusion provider, there is no limit to the growth of your career. Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team members including 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and employees. As a two-year recipient of the Gallup Exceptional Workplace Award, we recognize that part of being extraordinary is building a thriving workforce that is as unique as the patients and communities we serve. Join a company that is taking action to develop a culture that is inclusive, respectful, engaging and rewarding for all team members. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a culture that attracts, hires and retains the best and brightest talent in healthcare.

Responsibilities

• Submits timely, accurate invoices to payer for products and services provided.
• Understands the terms and fee schedule for all contracts for which invoices are submitted.
• Correctly determines quantities and prices for drugs billed.
• Verifies that the services and products are correctly authorized and that required documentation is on file.
• Ensures that invoices are submitted for services and products that are properly ordered and confirmed as provided.
• Evaluates payments received for correctness and applies payments accurately to the system.
• Verifies that payments received are correct according to the fee schedule.
• Applies the payment correctly to the patient account.
• Ensures that secondary bills and patient invoices are mailed within 48 hours of receipt of payment.
• Notifies the Reimbursement Manager if there are overpayments and/or duplicate payments for the same service.
• Transfers payments belonging to other offices within 48 hours of receipt.
• Follows up on invoices submitted to ensure prompt and timely payment.
• Calls to verify that claims submitted were received and are in processing.
• Sends letters to the patient or responsible party when their insurance carrier fails to make payment reasonable time frame.
• Generates and mails statements and collections letters.
• Follows-up on all denials within 48 hours of receipt.
• Ensures compliance with policies and guidelines outlined in the contract terms and fee schedule.
• Follows HIPPA guidelines when accessing and sharing patient information to maintain patient and business confidentiality.

Requirements

• High School Diploma or equivalent.
• 0 – 6 months previous Infusion Reimbursement or Intake/Admissions experience.
• Basic level skill in Microsoft Excel.
• Basic level skill in Microsoft Word.

Benefits

• 401k
• Dental Insurance
• Disability Insurance
• Health Insurance
• Life Insurance
• Paid Time off
• Vision Insurance