Lead Collections Specialist at BioMatrix Specialty Pharm

Overland Park, Kansas, United States -

Full Time

Start Date

Immediate

Expiry Date

03 Jun, 26

Salary

28.12

Posted On

06 Mar, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims Submission, Follow-up, Payment Processing, Delinquent Balances, Reimbursement Management, Collections Monitoring, Corrective Action, Account Resolution, Compliance, HIPAA, Customer Inquiries, Medical Terminology, Revenue Cycle, Insurance Billing, ICD-10, HCPCS

Industry

Hospitals and Health Care

Description

BioMatrix is a nationwide, independently-owned infusion pharmacy with decades of experience supporting patients on specialty medication. Our compassionate care team helps patients navigate the often-challenging healthcare environment. We treat our patients like family and get them started on therapy quickly. We work closely with them as well as their family and their healthcare providers throughout the patient journey, staying focused on optimal clinical outcomes. At BioMatrix the heart of our Inclusion, Diversity, Equity, & Access (IDEA) philosophy is the commitment to cultivate a welcoming space where everyone’s contributions are acknowledged and celebrated. Our goal is to draw in, develop, engage, and retain talented, high-performing individuals from diverse backgrounds and viewpoints. We believe that both respecting and embracing diversity enriches the experiences and successes of our patients, employees, and partners. Schedule and Location: Monday Through Friday Between 8 am Central Standard Time & 5:00pm Central Standard Time It is anticipated that an incumbent in this role is onsite in Overland Park, KS, may consider hybrid after 6 months of evaluation. The Lead Collections Specialist serves in a lead capacity to functionally assist the RCM Collections Manager with the training and support of the Collections Specialists. They are responsible for claims submission follow-up for correct and timely payment to achieve the goal of low delinquent payer balances and ensuring the effective and efficient management of the assigned collections / reimbursement. This position will also monitor collections activity and develop necessary corrective action to resolve deficiencies and assist other team members with difficult accounts. Ensures all compliance, legal and regulatory requirements are met when interacting with all Internal and External customers. Ensures customer inquiries are resolved in a timely professional manner. QUALIFICATION REQUIREMENTS 5-7 years’ experience in high volume pharmacy/infusion billing and collections, preferred. High School Diploma or equivalent Understanding of basic medical terminology Understanding and knowledge of revenue cycle, insurance billing and collections, Medicare, Medicaid, 3rd party payors. Knowledge of Coding ICD-10, HCPCS, CPT, HER preferred Understanding insurance audits, and other external actions that impact revenue Maintains strictest confidentiality of patient information in compliance with HIPAA and state and federal regulations Strong verbal and written communication skills to individuals and business at all different education levels Advanced computer skills and knowledge of office software packages. MS Office (Excel, Word). QUALIFICATIONS PREFERRED CPR+ experience not required, but a bonus. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES Assist by providing adequate resources and training for new employees Support team members daily with problematic accounts Provide clear and compelling direction to team members, etc. Collection calls and/or correspondence to payers for status of submitted claims Review of EOB’s for correct payment, denials, zero and short pays or additional information required to process claims Submit secondary claims, appeals for denials or short pays, appeal letters, claims review forms Submit a “CIF” (Claim Inquiry Form) for Medicaid such as California, or other states required forms Accountable for reducing delinquency for assigned accounts, reducing bad debt Monitor overall company aging and payor specific trends reporting Identifies, reports and responds to overpayment requests and recoupments Establish and maintain effective and cooperative working relationships with payors Enlist the efforts of sales and senior management when necessary to accelerate the collection process Utilize billing system to manage and update claims status Communicate and follow up with billing regarding customer accounts discrepancies and billing procedures Weekly/Monthly reporting to direct supervisor, management as requested Perform other assigned tasks and duties as necessary to support the Accounts Receivable Department NON-ESSENTIAL FUNCTIONS & RESPONSIBILITIES Ability to prioritize and handle multiple tasks and projects concurrently. Must have scheduling flexibility and be able to work overtime. Careful attention to detail. Performs related duties as requested. Participates in quality assurance activities and audits as directed. KNOWLEDEGE, SKILLS AND ABILITIES REQUIREMENTS Ability to actively communicate with all levels of staff. Ability to maintain accurate records and prepare reports and correspondence related to the work. Ability to maintain favorable public relations. Excellent verbal, written, and communication skills. Communication Skills Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; Participates in meetings. Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information. Computer Skills Become and remain proficient in all programs necessary for execution. BioMatrix Pay Range/Rate $28.12—$28.12 USD 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 may be made to enable individuals with disabilities to perform the essential functions. If needing a reasonable accommodation within the application process, please contact the BioMatrix People & Culture team at Careers@BioMatrixsprx.com or 954.385.7322 x 1425. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. OTHER Will participate in legal and ethical compliance training each year. Will consistently behave in compliance with the BioMatrix, LLC’s legal and ethical policies and procedures. Will abide by the policies of BioMatrix, LLC as set forth in the Compliance Manual. Will not participate in any conduct considered to be unethical or illegal. EXPECTATION FOR ALL EMPLOYEES Supports the organization's mission, vision, and values by exhibiting the following behaviors: integrity, dedication, compassion, enrichment and enthusiasm, places patients first, is all-in with stacked-hands, and is focused on relentless consistency wins. GENERAL INFORMATION: The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required of personnel so classified. The incumbent must be able to work in a fast-paced environment with demonstrated ability to juggle and prioritize multiple, competing tasks and demands and to seek supervisory assistance as appropriate. Incumbents within this position may be required to assist or find appropriate assistance to make accommodations for disabled individuals in order to ensure access to the organization's services (may include: visitors, patients, employees, or others). All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Responsibilities

The Lead Collections Specialist assists the RCM Collections Manager with training and supporting Collections Specialists, focusing on claims submission follow-up to ensure timely payment and low delinquent payer balances. This role involves monitoring collections activity, developing corrective actions for deficiencies, and assisting team members with difficult accounts while ensuring compliance.