Medical Claims Follow-Up and Appeals Writing Specialist Job at Soleo Health in F

Soleo Health; Frisco (TX); Remote; USD 80,000 - 100,000; Full time

Job summary

Soleo Health is seeking a Medical Claims Follow-Up and Appeals Writing Specialist to work remotely. This role involves managing medical accounts receivable, ensuring timely payments, and providing exceptional customer service. Ideal candidates will have a strong background in collections, excellent communication skills, and knowledge of medical terminology. Join a company committed to improving patient lives and fostering a diverse workplace.

Benefits

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 options

Paid Time Off

Qualifications

• 1-3 years of strong collections and appeals experience required.
• Knowledge of HCPC coding and medical terminology.

Responsibilities

• Researches balances on accounts receivable and takes necessary collection actions.
• Identifies billing errors and resolves unpaid claims.
• Writes detailed appeals with supporting documentation.

Skills

Communication

Organizational Skills

Problem Solving

Interpersonal Skills

Education

High school diploma or equivalent

Associate degree in finance, accounting, or related field

Tools

Word

Excel

Outlook

Job description

Soleo Health is seeking an Medical Claims Follow-Up and Appeals Writing Specialist (Collection Specialist) to work Remotely (USA). Join us in Simplifying Complex Care!

• 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

The Position : The Medical Claims Follow-Up and Appeals Writing 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
• 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

Requirements

• 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
• 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, hiring now, immediately hiring

Salary Description

20-$25

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