RCM / Collections Specialist / Medical Biller - Remote - Central Time Zone

📋 Description

• • As an RCM / Collections Specialist / Medical Biller at Option Care Health, you will play a crucial role in ensuring the financial health of our organization by managing the revenue cycle for home infusion services. Your primary responsibility will be the accurate and timely submission of invoices to all types of payers, ensuring that all services and products provided are correctly billed and accounted for.
• • You will be tasked with understanding the intricate terms and fee schedules associated with various payer contracts. This involves meticulously verifying quantities and prices for drugs billed, confirming that all services and products were properly authorized, and that the necessary documentation is on file. A key aspect of this role is ensuring that invoices are submitted only for services and products that have been legitimately ordered and confirmed as delivered.
• • A significant part of your day-to-day will involve evaluating incoming payments for accuracy and applying them precisely to patient accounts. This requires a keen eye for detail to verify that payments align with the contracted fee schedules. You will be responsible for the correct application of these payments within our system, ensuring that secondary bills and patient invoices are processed and mailed within 48 hours of payment receipt.
• • Proactive follow-up on submitted invoices is essential to guarantee prompt and timely payment. This includes contacting payers to confirm claim receipt and processing status. You will also be responsible for initiating communication with patients or responsible parties when their insurance carriers fail to process payments within a reasonable timeframe. This involves generating and mailing statements and collection letters.
• • You will diligently follow up on all denied claims within 48 hours of receipt, working to resolve issues and secure payment. This may involve investigating the reasons for denial and taking corrective actions to resubmit claims.
• • A critical component of this role is ensuring strict adherence to all policies and guidelines outlined in contract terms and fee schedules. You will also be responsible for upholding HIPAA guidelines when accessing and sharing patient information, maintaining the utmost confidentiality of patient and business data.
• • This position offers a unique opportunity to contribute to an organization that is a leader in home and alternate site infusion services. You will be part of a team dedicated to elevating standards of care and re-imagining the infusion care experience.
• • You will assist with Billing and Collection Training, sharing your expertise with colleagues and contributing to the overall efficiency of the revenue cycle management team.
• • You will also complete "second level" appeals to payers, requiring a thorough understanding of billing processes and payer requirements to effectively challenge claim denials and recover revenue.
• • The role demands strong organizational skills, attention to detail, and the ability to manage multiple tasks efficiently in a remote work environment.
• • You will be expected to maintain a high level of accuracy in all billing and payment application processes.
• • This position is ideal for an individual who is proactive, detail-oriented, and possesses a strong understanding of medical billing and collections principles.
• • You will contribute to a culture that values respect, engagement, and rewarding contributions, making a tangible impact on patient care through efficient financial operations.
• • The ability to work independently and as part of a remote team is paramount.
• • You will be a key player in ensuring that Option Care Health continues to provide extraordinary care by maintaining robust financial processes.
• • This role requires a commitment to continuous learning and adaptation to evolving healthcare billing regulations and payer policies.
• • You will be instrumental in identifying and resolving billing discrepancies and payment issues.
• • Your work will directly impact the company's revenue stream and operational efficiency.
• • You will collaborate with internal teams to ensure seamless patient care delivery from a financial perspective.
• • The role involves utilizing various software systems for billing, payment posting, and account reconciliation.
• • You will be expected to meet performance metrics related to claim submission timeliness, denial rates, and collection rates.
• • This is an opportunity to grow your career within the nation's largest independent home and alternate site infusion services provider.