Collections Specialist
BioMatrix Specialty Pharmacy, Overland Park, KS, United States
Collections Specialist
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. Monday through Friday between 8am Central Standard Time & 4:30pm 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 collections specialist is responsible for claims submission follow-up for correct and timely payment to achieve the goal of low delinquent payer balances for all therapy types. This position is responsible for ensuring the effective and efficient management of the assigned collections/reimbursement for payors. Also, monitors collections activity and develops necessary corrective action to resolve deficiencies, denials and all unpaid open balances. 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: GED or high school diploma required Minimum of three (3) years of working experience in collection related activities required Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction. Basic level skill in Microsoft Office (including Word, Excel, PowerPoint, etc.). Qualifications Preferred: Minimum of five (5) years of working experience in collection related activities preferred Previous home infusion therapy billing experience preferred Essential Functions and Responsibilities: Following up on insurance claims to ensure timely payment. Working with insurance companies to resolve any denials or short payments. Communicating effectively with internal teams to ensure smooth operations. Understanding when a claim was billed correctly vs when it is not. Have a thorough understanding of payer contracts. Understanding the different types of home infusion medications and therapies. Knowledge of insurance verification and reimbursement processes. Address customer inquiries and resolve billing discrepancies, providing excellent customer service to both internal and external stakeholders. Stay updated on relevant billing regulations, coding guidelines, and payer requirements, ensuring compliance with all applicable standards. Familiarity with clearinghouses and the billing functionality. Assist with various data entry, administrative, and clerical tasks. Knowledge, Skills and Abilities Requirements: Able to stay abreast of payer alerts and reimbursement changes. Able to work in a fast-paced environment. Able to navigate and interpret insurance contracts. Ability to actively communicate, inspire and motivate all levels of staff. Ability to think and act strategically and proactively. Ability to maintain accurate records and prepare reports and correspondence related to the work. Ability to organize and coordinate the work of others. Ability to set priorities and assign work to other professionals. Excellent analytical skill. Communication Skills Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions; demonstrates group presentation skills; 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 is all programs necessary for execution. Physical Demands and Work Environment: This position requires constant sitting with occasional walking, standing, kneeling or stooping. This position requires the use of hands to finger, handle or feel objects and the ability to reach with hands and arms. This position requires constant talking and hearing. Specific vision abilities required by this job include close vision and the ability to adjust focus. This position must occasionally lift and/or move up to 20 pounds. Required to move/lift physical hardware. 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.
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. Monday through Friday between 8am Central Standard Time & 4:30pm 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 collections specialist is responsible for claims submission follow-up for correct and timely payment to achieve the goal of low delinquent payer balances for all therapy types. This position is responsible for ensuring the effective and efficient management of the assigned collections/reimbursement for payors. Also, monitors collections activity and develops necessary corrective action to resolve deficiencies, denials and all unpaid open balances. 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: GED or high school diploma required Minimum of three (3) years of working experience in collection related activities required Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction. Basic level skill in Microsoft Office (including Word, Excel, PowerPoint, etc.). Qualifications Preferred: Minimum of five (5) years of working experience in collection related activities preferred Previous home infusion therapy billing experience preferred Essential Functions and Responsibilities: Following up on insurance claims to ensure timely payment. Working with insurance companies to resolve any denials or short payments. Communicating effectively with internal teams to ensure smooth operations. Understanding when a claim was billed correctly vs when it is not. Have a thorough understanding of payer contracts. Understanding the different types of home infusion medications and therapies. Knowledge of insurance verification and reimbursement processes. Address customer inquiries and resolve billing discrepancies, providing excellent customer service to both internal and external stakeholders. Stay updated on relevant billing regulations, coding guidelines, and payer requirements, ensuring compliance with all applicable standards. Familiarity with clearinghouses and the billing functionality. Assist with various data entry, administrative, and clerical tasks. Knowledge, Skills and Abilities Requirements: Able to stay abreast of payer alerts and reimbursement changes. Able to work in a fast-paced environment. Able to navigate and interpret insurance contracts. Ability to actively communicate, inspire and motivate all levels of staff. Ability to think and act strategically and proactively. Ability to maintain accurate records and prepare reports and correspondence related to the work. Ability to organize and coordinate the work of others. Ability to set priorities and assign work to other professionals. Excellent analytical skill. Communication Skills Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions; demonstrates group presentation skills; 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 is all programs necessary for execution. Physical Demands and Work Environment: This position requires constant sitting with occasional walking, standing, kneeling or stooping. This position requires the use of hands to finger, handle or feel objects and the ability to reach with hands and arms. This position requires constant talking and hearing. Specific vision abilities required by this job include close vision and the ability to adjust focus. This position must occasionally lift and/or move up to 20 pounds. Required to move/lift physical hardware. 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.