RCM / Collections Specialist / Medical Biller
Option Care Home Health LLC
Nashville, TNFresher50m agovia LinkedIn
About the Role
Responsible for the timely, accurate submission of invoices to responsible payer for all services and products provided. Evaluates payments received and application to the patient account. Follows-up with responsible parties to ensure the receipt of timely, accurate payments. Assists with Billing and Collection Training and completes "second level" appeals to payers.
Applicants must currently reside in the Eastern Time Zone to be considered.
The starting target pay range is $20-22/hr.
Key Responsibilities
- Submit timely, accurate invoices to payers for products and services provided.
- Understand contract terms and fee schedules for all invoiced contracts.
- Correctly determine quantities and prices for drugs billed.
- Verify that services and products are correctly authorized and required documentation is on file.
- Ensure invoices are submitted for services and products that are properly ordered and confirmed as provided.
- Evaluate payments received for correctness and apply payments accurately to the system.
- Verify that payments received are correct according to the fee schedule.
- Apply payments correctly to the patient account.
- Ensure secondary bills and patient invoices are mailed within 48 hours of payment receipt.
- Notify the Reimbursement Manager of overpayments and/or duplicate payments for the same service.
- Transfer payments belonging to other offices within 48 hours of receipt.
- Follow up on invoices submitted to ensure prompt and timely payment.
- Call to verify claim receipt and processing status.
- Send letters to patients or responsible parties when their insurance carrier fails to make payment within a reasonable timeframe.
- Generate and mail statements and collections letters.
- Follow up on all denials within 48 hours of receipt.
- Ensure compliance with policies and guidelines outlined in contract terms and fee schedules.
- Follow HIPAA guidelines when accessing and sharing patient information to maintain patient and business confidentiality.
Requirements & Tech Stack
- Basic level skill in Microsoft Excel
- Basic level skill in Microsoft Word
Qualifications
- High School Diploma or equivalent.
- 0 – 6 months previous Infusion Reimbursement or Intake/Admissions experience.