CSI Revenue Cycle Collector (H)

Job Title 

Location

Employee Type

Working Hours Per Week

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Other duties may be assigned, as necessary.

· FOLLOW UP ON OUTSTANDING MEDICAL CLAIMS WITH INSURANCE COMPANIES, PATIENTS, AND HEALTHCARE PROVIDERS.

· WORK WITH INSURANCE COMPANIES TO RESOLVE DISPUTES AND FACILITATE PAYMENT.

· COMMUNICATE WITH INSURANCE COMPANIES TO RESOLVE BILLING AND PAYMENT ISSUES.

· MAINTAIN DETAILED ELECTRONIC RECORDS AND NOTES OF ALL PATIENT AND PAYER COMMUNICATION.

· RESOLVE DENIED CLAIMS AND APPEALS.

· INITIATE REQUESTS FOR ADJUSTMENTS TO REVENUE WITH SUPPORTING DOCUMENTATION WHERE APPROPRIATE.

· ACCURATELY INTERPRET AN EXPLANATION OF BENEFITS.

· PROCESS REFUND REQUESTS FROM PAYERS ACCURATELY AND TIMELY.

· ENSURE THAT ALL CLAIMS ARE PROCESSED FOLLOWING INDUSTRY REGULATIONS AND STANDARDS.

· ADHERE TO ALL HIPAA GUIDELINES/REGULATIONS.

· PERFORMS OTHER RELATED DUTIES AS ASSIGNED OR REQUESTED.

QUALIFICATION REQUIREMENTS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions. Ability to work effectively with colleagues as team members and to communicate effectively.

· Possess the ability to multi-task and frequently change direction.

· Time management skills.

· Strong knowledge of infusion medical billing codes, insurance contracts, and regulations.

· Familiarity with pharmacy/infusion insurance claims and appeal process.

· Strong attention to detail and problem-solving skills.

· Experience with home infusion and/or specialty pharmacy.

· Experience with CareTend preferred

EDUCATION AND/OR EXPERIENCE

· High School Diploma/GED

· College degree preferred or equivalent experience.

· 1-3 years experience in infusion medical billing and/or collections.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk or listen. The employee regularly is required to stand, walk, sit, climb stairs, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

The employee frequently lifts and/or moves up to 20 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

This job generally operates in a clerical office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines. While performing the duties of this position, the employee may travel by automobile and be exposed to changing weather conditions.

NOTICE: Successful completion of a drug screen prior to employment is part of our background process, which includes medical and recreational marijuana.

By supplying your phone number, you agree to receive communication via phone or text.

CSI Pharmacy is an Equal Opportunity Employer