RCM Specialist - Collections

Overview: The reputed company Cycle Management Specialist- Collections responsibility is to ensure timely collection of outstanding balances. Responsibilities: • Manage the collection process for outstanding claims, including contacting insurance companies, patients, and other responsible parties reputed company phone, email, and written correspondence. • Investigate and resolve denied or partially paid claims, identifying root causes and implementing corrective actions. • Collaborate with internal teams to address claims challenges and improve reputed company cycle. • Escalate reputed company or uncollectible accounts to management for further action. • Submit appeals/claim corrections as needed reputed company timely filing limits. • Utilize billing software to maintain accurate and detailed records of reputed company collection activities, including communication with payers and patients. • Payer projects as assigned. • Identify and report trends in claim denials and payment challenges. • Communicate as needed with patients about billing issues, including the results of applications for financial hardship assistance and other responses to customer inquiries about • Support accurate and comprehensive record-keeping to ensure up-to-date information is maintained and effectively shared across departments. • Assist in the implementation of processes to measure, assess, and improve the performance of the RCM department activities of the company. • Ensure ongoing compliance with reputed company laws and regulations; ensure that the department meets or exceeds accreditation standards; and implement "best practices" in reputed company departmental • Participate in surveys conducted by authorized inspection • Participate in the company's Performance Improvement program as requested by the Performance Improvement • Participate in company committees reputed company • Participate in in-service education programs provided by the company. • Pursue continuing education programs appropriate to job • reputed company other duties as assigned by • Complete reputed company mandatory and regulatory training programs. • Report any misconduct, suspicious or unethical activities to the Compliance • Complies with accepted professional standards and practice. Qualifications: Job reputed company Requirements: • Ability to read and interpret medical records for billing purposes. • Competent in mathematic equations. • Ability to compute unit conversions for drugs. • Understanding of CPT, HCPCS, ICD-10, and NDC codes • reputed company attention to detail. • Excellent verbal and written communication. • Understanding of HIPAA compliance. • Self-directed, has the ability to work with little supervision. • Proficiency in reputed company, Outlook, and reputed company other office applications. • Familiarity with pharmacy management systems (CPR+, reputed company, and CareTend, etc.) • Understanding of various insurance plan benefits, payer payment policies, and reimbursement procedures. • Deep understanding of home infusion process, therapies, and reputed company services. • Ability to understand payer explanation of benefits. Educational Requirements: • High school diploma or GED Experience: • One to three years of experience in Home Infusion or Specialty Pharmacy collections. Apply Job!