Collection and Appeals Specialist

Soleo Health is seeking an Advanced Infusion Collection and Appeals Specialist to work Remotely (USA). Join us in Simplifying Complex Care!

Soleo Health Perks:

• Competitive Wages
• 401(k) with a match
• Referral Bonus
• Great company culture
• Paid parental leave options
• Affordable Medical, Dental, and Vision Insurance Plans
• Company Paid Disability and Basic Life Insurance
• HSA and FSA (including dependent care) options
• Paid Time Off
• Education Assistant Program

The Position: The Advanced Infusion Collection and Appeals Specialist is responsible for a broad range of collection processes related to medical accounts receivable in support of multiple site locations. The Advanced Infusion Collections and Appeals Specialist will proactively work assigned accounts to maximize accurate and timely payment. Responsibilities include:

• Researches all balances on the accounts receivable and takes necessary collection actions to resolve in a timely manner
• Researches assigned correspondence; takes necessary action to resolve requests
• Routinely reviews and works correspondence folder requests in a timely manner
• Makes routine collection calls on outstanding claims
• Identifies billing errors, short payments, unpaid claims, cash application issues and resolves accordingly
• Ability to identify potential risk, write offs and status appropriately and report and escalate to management on as identified.
• Researches refund requests received by payers and statuses refund according to findings
• Documents detailed notes in a clear and concise fashion in Company software system
• Identifies issues/trends and escalates to Manager when assistance is needed
• Provides exceptional Customer Service to internal and external customers
• Ensures compliance with federal, state, and local governments, third party contracts, and company policies
• Must be able to communicate well with branch, management, patients and insurance carriers
• Ability to perform account analysis when needed
• Answering phones/taking patient calls regarding balance questions
• Using portals and other electronic tools
• Ensure claims are on file after initial submission
• Identifies, escalates, and prepares potential payor projects to management and company Liaisons
• Write detailed appeals with supporting documentation
• Keep abreast of payor follow up/appeal deadlines
• Submits secondary claims

Schedule:

• Monday-Friday, 8:30a-5pm Pacific Time
• Overtime as necessary

• High school diploma or equivalent; an associate degree in finance, accounting, or a related field is preferred.
• 1-3 years or more of strong collections and appeals experience required
• Previous Home Infusion and Specialty Pharmacy experience highly preferred
• Knowledge of HCPC coding and medical terminology
• CPR+ systems experience preferred
• Excellent math and writing skills
• Excellent interpersonal, communication and organizational skills
• Ability to prioritize, problem solve and multitask
• Word, Excel and Outlook experience

About Us: Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference!

Soleo’s Core Values:

• Improve patients’ lives every day
• Be passionate in everything you do
• Encourage unlimited ideas and creative thinking
• Make decisions as if you own the company
• Do the right thing
• Have fun!

Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture.

Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.

Keywords: collector, specialty pharmacy, AR, payor denials, appeals, follow-up, denial support , hiring immediately, now hiring