Remote Collections Specialist, Self Pay

CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services.

Job Details:

The Collections Specialist is responsible for managing Self-Pay Collections, ensuring timely and accurate payment of claims, handling in-bound patient calls, and reviewing co-pay assistance claims. The ideal candidate will have strong customer service skills, communication and problem-solving skills and working in a fast paced environment. This role involves investigating accuracy and account review with the goal of resolving discrepancies and maximizing reimbursement. Prior knowledge of home infusion, medical billing practices, and payer reimbursement guidelines is preferred. The position requires attention to detail, the ability to work independently, and proficiency with Microsoft 365. Experience with ICD-10, CPT-4, HCPCS, and medical terminology is preferred.

Responsibilities

Strong customer service and interpersonal skills. Call volumes expected to vary throughout the month.

Effective written and verbal communication.

Excellent organization, problem solving skills and attention to detail.

Meet the quality assurance and benchmark standards set by the management team

Contact the payer, or patient as appropriate.

Documents all collections activity in patient collections notes.

Documents work performed/action taken on AR Reports.

Reviews claim processing to determine proper payment has been issued.

Request and process all approved adjustments.

Reviews patient information in appropriate system to determine why the claim is unpaid, if an adjustment is valid, and whether additional approval is required.

Ability to identify errors, correct claims and reprocess for reimbursement.

Ability to read and interpret an EOB for accurate understanding of claim processing.

Performs other duties as assigned. Skills & Abilities

Manage assigned book of business: Transfer of balance due, charging of patient ACH and Credit Card and one-time credit cards for copay assistance payments, and contractual adjustments requests of accounts.

Review accounts with patients and resolve questions or transfer to appropriate staff member. Inbound and outbound call volumes may vary throughout the month.

Review patient unapplied account and verify accuracy of payment prior to posting to the correct open account receivable.

Ability to communicate with patients, payors, outside agencies, and public through telephone, electronic and written correspondence.

Helpful, knowledgeable, and polite while maintaining a positive attitude.

Interpret a variety of instructions in a variety of communication mediums.

Maintain confidentiality and practice discretion and caution when handling sensitive information.

Multi-task along with attention to detail.

Ability to accurately perform simple mathematical calculations using addition, subtraction, multiplication, and division.

Self-motivation, organized, time-management and deductive problem-solving skills.

Work independently and as part of a team.

Collections or medical billing experience with basic understanding of ICD10, CPT4, HCPCS, and medical terminology is preferred.

Familiarity with third party payor guidelines and reimbursement practices and available financial resources for payment of balances due is beneficial.

HCN360 and CPR+ knowledge preferred.

Knowledge of Microsoft 365 products, including but not limited to Outlook, Teams and Excel. Requirements

High school graduate or equivalent.

Excellent interpersonal, organizational, communication and effective problem-solving skills are necessary.

CarepathRx offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire.

CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.