Job Abstract

AIS Healthcare is the leading provider of Targeted Drug Delivery (TDD), and Infusion Care. With our diverse culture, and our values around Innovation, Stewardship, and Unity, we are committed to Advancing Quality, and Improving Lives. We are dedicated to doing more for our patients by providing quality products and services that enhance the entire care experience.

Advanced Infusion Care is our home infusion division specializing in intravenous (IV) and subcutaneous (Sub Q) immunoglobulin therapy patient care.  We are looking for an experienced and motivated Accounts Receivable Medical Collection expert to join our dynamic team!  This role is a full-time position responsible for collection processes for our IG division.

The perfect candidate should have outstanding communication skills, an in-depth knowledge of collection practices, work in compliance with Federal and State rules, regulations, and policy related to billing and collection activities.  The ideal candidate should also understand contract analysis, reimbursement, denial management and appeal process.  CPR + experience is a Plus.

We offer great benefits, including health, vision and dental insurance, long term disability insurance, life insurance, a vacation package, 401K plan with a generous employer match, hybrid office/ Remote work from home opportunity, growth, and more

Job Summary: 

The Collections position is a full-time position responsible for assisting in the medical collections efforts for our IG division. Collection processes for IG services include contract analysis, reimbursement, denial management, appeals and resolving billing-related issue with insurance companies or other responsible party for services rendered. 

EDUCATION AND EXPERIENCE:

·         A high school diploma or general education degree (GED) equivalent is required; bachelor’s degree preferred.

·         3-5 years of healthcare industry experience required.

·         3-5 years of medical billing and collections experience required.

·         Home Infusion, IG experience preferred.  

ESSENTIAL DUTIES AND RESPONSIBILITIES:

·         Responsible for contract analysis, accounts receivables, denials, claims monitoring, adjustments, appeals.

·         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.

·       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 maximizes reimbursement of claims.
• 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.

·         Recognizes patients’ rights and responsibilities and supports them in the performance of job duties, respects patient’s rights to privacy and confidentiality.

·         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.

QUALIFICATION REQUIREMENTS:

·         Understanding of all Revenue Cycle Management functions and integration of one another.

·         Ability to recognize, evaluate and exercise good judgment in solving complex situations and advising in accordance with laws and regulations.

·         Excellent verbal and written communication and relationship building skills with an ability to prioritize, negotiate, and work with a variety of internal and external stakeholders.

·         Strong work ethic with personal qualities of integrity and credibility.

·         Ability to deal with highly sensitive and confidential material, strong knowledge of HIPAA privacy guidelines and requirements.

·         Competence with ICD-9 and ICD-10.

·         Knowledge of medical terminology.

·         Ability to communicate effectively and professionally with patients, visitors, physicians, and coworkers.

·         Self-directed, detail oriented, conscientious, organized, and able to follow through.

·         Ability to deal in an organized manner with problems involving multiple variables within the scope of the position.

·         Skill in establishing and maintaining effective working relationships with other employees, patients, organizations, and the public.

·        Proficient in Microsoft Office, including Outlook, Word, and Excel.