RCM / Collections Specialist / Medical Biller - Remote - PST or MST Only

Option Care Enterprises; Santa Fe (NM); Remote; USD 35,000 - 50,000; Full time

Benefits offered by this job

Medical, Dental, & Vision Insurance

Paid Time off

Bonding Time Off

401K Retirement Savings Plan with 401K

HSA Company Match

Flexible Spending Accounts

Tuition Reimbursement

myFlexPay

Family Support

Mental Health Services

Company Paid Life Insurance

Award/Recognition Programs

Job summary

Option Care Health, Inc. in the United States seeks a reimbursement/billing specialist. Applicants must reside in the Mountain or Pacific Time Zone to be considered. You will submit invoices for drugs and services, evaluate payments, and ensure timely postings to patient accounts.

You will also follow up on denials, assist with training, and perform second-level payer appeals, while adhering to HIPAA guidelines to protect patient information.

Qualifications

• High School Diploma or equivalent.
• 0–6 months Infusion Reimbursement or Intake/Admissions experience.

Responsibilities

• Submits timely, accurate invoices to payer for products and services provided.
• Evaluates payments received and applies to the patient account.
• Follows up with payers to ensure timely, accurate payments.
• Assists with Reimbursement Training and completes second-level payer appeals.
• Maintains HIPAA/compliance when accessing patient information.

Skills

Microsoft Excel

Microsoft Word

Education

High School Diploma or equivalent

Job description

Extraordinary Careers. Endless Possibilities.

With the nation's largest home infusion provider, there is no limit to the growth of your career.

Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team members including 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and team members.

Join a company that is taking action to develop an inclusive, respectful, engaging and rewarding culture for all team members. At Option Care Health your voice is heard, your work is valued, and you're empowered to grow. Cultivating a team with a variety of talents, backgrounds and perspectives makes us stronger, innovative, and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a culture that attracts, hires and retains the best and brightest talent in healthcare.

Job Description Summary:

Applicants must currently reside in the Mountain OR Pacific Time Zone to be considered

Responsible for the timely, accurate submission of invoices to responsible payer, of any type, 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.

Job Responsibilities:

Submits timely, accurate invoices to payer for products and services provided. Understands the terms and fee schedule for all contracts for which invoices are submitted. Correctly determines quantities and prices for drugs billed. Verifies that the services and products are correctly authorized and that required documentation is on file. Ensures that invoices are submitted for services and products that are properly ordered and confirmed as provided.

Evaluates payments received for correctness and applies payments accurately to the system. Verifies that payments received are correct according to the fee schedule. Applies the payment correctly to the patient account. Ensures that secondary bills and patient invoices are mailed within 48 hours of receipt of payment. Notifies the Reimbursement Manager if there are overpayments and/or duplicate payments for the same service. Transfers payments belonging to other offices within 48 hours of receipt.

Follows up on invoices submitted to ensure prompt and timely payment. Calls to verify that claims submitted were received and are in processing. Sends letters to the patient or responsible party when their insurance carrier fails to make payment reasonable time frame. Generates and mails statements and collections letters. Follows-up on all denials within 48 hours of receipt.

Ensures compliance with policies and guidelines outlined in the contract terms and fee schedule. Follows HIPPA guidelines when accessing and sharing patient information to maintain patient and business confidentiality.

Basic Education and/or Experience Requirements:

• High School Diploma or equivalent.
• 0 - 6 months previous Infusion Reimbursement or Intake/Admissions experience

Basic Qualifications & Interests:

Basic level skill in Microsoft Excel (for example: opening a workbook, inserting a row, selecting font style and size, formatting cells as currency, using copy, paste and save functions, aligning text, selecting cells, renaming a worksheet, inserting a column, selecting a chart style, inserting a worksheet, setting margins, selecting page orientation, using spell check and/or printing worksheets).

Basic level skill in Microsoft Word (for example: opening a document, cutting, pasting and aligning text, selecting font type and size, changing margins and column width, sorting, inserting bullets, pictures and dates, using find and replace, undo, spell check, track changes, review pane and/or print functions).

Benefits:

• Medical, Dental, & Vision Insurance
• Paid Time off
• Bonding Time Off
• 401K Retirement Savings Plan with Company Match
• HSA Company Match
• Flexible Spending Accounts
• Tuition Reimbursement
• myFlexPay
• Family Support
• Mental Health Services
• Company Paid Life Insurance
• Award/Recognition Programs

Due to state pay transparency laws, the full range for the position is below: Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.

Option Care Health subscribes to a policy of equa