Reimbursement Collection Specialist I

Axium Healthcare Pharmacy, Inc.; Florida; On-site; USD 36,000 - 60,000; Full time

Job summary

Axium Healthcare Pharmacy, Inc. is seeking a Reimbursement Collection Specialist I to manage outstanding claims and patient balances nationwide from our Lake Mary, Florida-based team.

You will follow up on denials, work with payers to secure payments, document collections, and support audits while collaborating in a fast-paced billing environment. Prior billing experience is preferred; strong attention to detail and communication are essential.

Qualifications

• High School Diploma or equivalent; Associate degree or billing certificate preferred.
• Two years related healthcare billing experience recommended.
• Ability to read and comprehend simple instructions and memos; effective written communication.

Responsibilities

• Timely follow-up on all assigned claims to secure payment.
• Work with payers to determine reasons for denials and reprocess claims.
• Reduce claims in over-90-day categories.
• Collect patient responsibility.
• Document all transactions in required systems.
• Mail, fax or email collections correspondence.
• Handle incoming calls related to Billing/Collections.
• Identify uncollectible accounts and obtain approval for bad debt write-offs.
• Maintain relationships with insurance companies.
• Assist with external audits.
• Cross-train and fill in in other areas as needed.
• Complete daily, weekly and monthly tasks per standards.

Skills

Language skills

Mathematical skills

Reasoning ability

Computer skills

Education

High school diploma

Associate degree / billing certificate

Tools

Outlook

Microsoft Word

Excel

Job description

At Axium Healthcare Pharmacy, Inc., we believe in a better quality of life for patients and their healthcare partners when treating and managing the most complex conditions. We believe in relationships that make life easier, and where a helping hand and better clinical, economical, and overall health outcomes are always within reach, 24 x 7 x 365. Our mission is simple. We aim to partner with and guide our patients to their best possible outcomes. Our longstanding vision is to help our patients and healthcare providers reach and create a better path to treating and managing complex conditions, making their lives easier and giving them hope for a healthier future. Specialty pharmacy is not a new concept. In fact, Axium did not invent specialty pharmacy. But, we did invent a better way to do it. We do it through a combination of clinical expertise, nationwide reach and the delivery of committed, caring, unmatched service and support for everyone, every time with no excuses. And, we’ve been doing it for years. We invite you to ask us what we can do for you. Our answer to you will almost always be: “Yes, we do.” Established in 2000 and based in Lake Mary, Florida, Axium is a nationwide clinical specialty pharmacy that makes life easier for those managing chronic disease and complex therapies by offering a helping hand and a better path to therapy management. We are licensed and permitted to operate in all 50 states and Puerto Rico, and specialize in providing patients, physicians, nurses, health plans, and other health care providers and partners with injectable and oral brand-name products. Our focus is to “Improve outcomes one relationship at a time,” and we achieve this through an experienced patient care team of doctors of pharmacy, registered nurses, reimbursement specialists, and dedicated patient care coordinators; all of whom deliver the highest level of comprehensive care and clinical support with every prescription.

Job Description

The Reimbursement Collection Specialist I is responsible for collecting outstanding receivables from insurance companies, patients and physicians.

ESSENTIAL DUTIES AND RESPONSIBILITIES:Include the following. Other duties may be assigned.Ensures timely follow-up on all assigned claims to secure timely paymentWorks with payers to determine reasons for denials, corrects and reprocesses claims for payment in a timely manner

• Reduces claims in the over 90-day categories
• Collects “Patient Responsibility” from the patient
• Accurately documents all transactions with carriers and patients regarding the financial status of claims and documents progressive collection efforts into the appropriate collection notes in all required computer systems
• Completes timely follow-up as required by department guidelines
• Demonstrates successful collection meetings by adhering to all collection guidelines and rules
• Mails, faxes or emails all appropriate collections correspondence
• Receives incoming calls related to the Billing/Collections Department
• Identifies uncollectible accounts and acquires approval for Bad-Debt Write/off
• Maintains relationships with insurance companies
• Generates and prepares patients statements and review them for accuracy prior to mailing
• Utilizes the Internet for Insurance claims status
• Assists with external audits
• Be willing to cross-train and fill-in in other areas within the department
• Works in an efficient and cohesive group environment
• Supports group and management efforts
• Completes daily, weekly and monthly tasks as required by department standards
  

Qualifications

QUALIFICATIONS: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 accommodations will be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE:High School Diploma or equivalent Associates Degree from college preferred or Certificate from a technical school for billing. Two years related experience in a healthcare environment and/or training; or equivalent combination of education and experience.

LANGUAGE SKILLS:Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to our patients, intermediary, carriers and internal customers.

MATHEMATICAL SKILLS:Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rates, ratios, and percentages.

REASONING ABILITY:Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to assess and resolve problems involving a few concrete variables in standardized situations.

COMPUTER and INTERNET SKILLS:Working knowledge of Outlook and Microsoft Word. The ability to create and populate simple Excel spreadsheets. Ability to navigate the web for the purpose of 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 will 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 sit and talk and hear. The employee is occasionally required to stand; walk; use hands to finger; handle or feel; and reach with hands and arms. Specific vision abilities required by this job include close vision, ability to adjust focus. The ability to perform heavy data entry or other computer function which requires extensive keyboard use. The ability to lift and move for short distances boxes or files with a weight not to exceed 25 pounds.

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 will be made to enable individuals with disabilities to perform the essential functions.Must be able to work in an environment of open-space cubicles where the noise level is usually quiet.

Additional Information

All your information will be kept confidential according to EEO guidelines.