Experienced BCBS Insurance Collections Specialist
About the position Responsibilities • Recognizes patients' rights and responsibilities and supports them in the performance of job duties, respects patient's rights to privacy and confidentiality. • Follows up on invoices submitted to ensure prompt and timely payment and escalates issues, as necessary. • Evaluates payments/denials received for correctness and ensures they are applied accordingly. • Identifies bad debt write-offs and A/R adjustments. • Initiates write-offs and adjustments in accordance with policies and procedures. • Identifies any overpayments and/or duplicate payments and investigates and resolves accordingly. • Processes refund requests, in accordance with policies and procedures. • Maintains contact with other departments to obtain patient or insurance information needed for claim payment. • Responsible for understanding all procedures within regulatory mandates. • Ensures that the activities of the collection operations are conducted in a manner that is consistent with overall department protocol, and are following Federal, State, and payer regulation, guidelines, and requirements. • Makes calls to troubleshoot payment discrepancies and establish resolution. • Documents, in detail, phone calls, phone number, person spoken to, and call details on a consistent basis. • Consistently looks for areas to maximize claim reimbursement. • Resolves issues that created a denial within 5 days of receipt of denial. • Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations. • Maintains understanding of NDC (National Drug Code) numbers, metric quantities, and knowledge of infusion supplies. • Maintains a broad range of knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes. • Shares knowledge gained with other staff members and works as a team member. • Interacts with others in a positive, respectful, and considerate manner. • Performs other job-related duties as assigned. Requirements • A high school diploma or general education degree (GED) equivalent is required. • 3-5 years of healthcare industry experience required. • 3-5 years of medical billing and collections experience required. • Home Infusion, Intrathecal Pain Management experience preferred. Benefits • Health insurance • Vision insurance • Dental insurance • Long term disability insurance • Life insurance • Vacation package • 401K plan with a generous employer match • 100% work from home model Apply tot his job