Collections Specialist

April 15

🔔 Pennsylvania – Remote

Although this job is listed in Pennsylvania, this company may be open to hiring remote in other states.

⏰ Full Time

🟡 Mid-level

🟠 Senior

📞 Collections

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CarepathRx

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CarepathRx is a comprehensive pharmacy care provider, partnering with health systems, hospitals, physicians, and pharmacies. The company offers a variety of solutions, including home and ambulatory infusion services, specialty pharmacy, and telepharmacy technology. CarepathRx aims to expand the continuum of infusion services to various settings such as the home, physician offices, and outpatient clinics to enhance patient experiences and retain patient services within their network. They also focus on leveraging remote pharmacy resources to provide cost-effective services like medication reconciliation and patient counseling. Through their expertise, operational scale, and technology capabilities, CarepathRx supports unique pharmacy strategies for their partners.

501 - 1000 employees

⚕️ Healthcare Insurance

💊 Pharmaceuticals

☁️ SaaS

💰 Corporate Round on 2020-12

📋 Description

• The Collections Specialist is responsible for managing third-party billing and collections. • Ensuring timely and accurate payment of claims, and processing payer appeals. • Investigating denials, processing rejections, and identifying root causes of payment issues. • Resolving discrepancies and maximizing reimbursement. • Contacting payer, or patient as appropriate. • Documenting all collections activity in patient collections notes. • Processing all Payer appeal requests within the time frame required by the Payer. • Ability to identify errors, correct claims and reprocess for reimbursement. • Maintaining productivity levels as defined by management. • Performing other duties as assigned.

🎯 Requirements

• High school graduate or equivalent • Excellent interpersonal, organizational, communication and effective problem-solving skills are necessary. • Knowledge of Home Infusion. • Knowledge of insurance policies, reimbursement practices, as well as claim processing requirements. • Knowledge of medical billing practices and of medical billing reimbursement. • Collections or medical billing experience with basic understanding of ICD10, CPT4, HCPCS, and medical terminology is preferred. • Familiarity with third party payor guidelines and reimbursement practices and available financial resources for payment of balances due is beneficial. • Medicare knowledge of billing requirements specific to DMEMAC. • HCN360 and CPR+ knowledge preferred. • Knowledge of Microsoft 365 products, including but not limited to Outlook, Teams and Excel. • Strong customer service skills.

🏖️ Benefits

• Medical, Dental and Vision Benefits for you and your family • Paid Company Holidays • Paid Time Off and Volunteer Time Off • 401(k) with Company Match • Company-paid Life Insurance and Disability Benefits • Supplemental Insurance packages