- Full Time/Contract
- Inglewood, CA
Our client is a clinical specialty pharmacy with an established track record in providing exemplary home infusion services. Unlike pharmacy chains, our client has a reputation of providing patients with comprehensive home infusion services in Southern California
They apply the latest advancements in medical technology while meeting the strictest eligibility guidelines, reimbursement conditions, and regulations of both public and private healthcare plans
Medical Collector Out of Network
- Under minimal supervision, responsible for collecting payments for medical claims on behalf of clients to generate collection fees (revenue) for Company.
- Previous experience with billing and collections on out of network and specialty infusion accounts.
- Contact third party payers to recover unpaid or partially paid claims on behalf of clients per Company’s accepted practices and in compliance with all state and federal laws pertaining to such actions.
- Bill or resubmit claims as needed for collection including all secondary claims per specific third-party payer regulations and state and federal medical billing guidelines.
- Provide third party payers with supporting information or documentation necessary for payment of claims and/or any other account follow-up (dictated by Company and client procedures) required to recover payments within the required timeframe
QUALIFICATIONS / REQUIREMENTS
- 2 years of Medical Collections experience required
- Experience collecting on Specialty Pharmacy (drug) Clams such as; Infusion, Dialysis and/or Oncology highly preferred
- Out of network Collections and Appeals experience
- Must have a comprehensive understanding of insurance company policies and be experienced in negotiating and executing workable strategies with insurance companies
- HS Diploma required
COMPENSATION & POSITION CLASSIFICATION
$20.00hr – $21.00/hr + Bonus
Full-Time; Contract / Potential Contract to Hire
Possibility of Overtime; As Required