BCBS AR / Collections Specialist
Company: AIS Healthcare
Posted on: November 22, 2021
AIS Healthcare is the leading provider of Targeted Drug Delivery
(TDD), Infusion Care and Ophthalmic solutions. 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.AIS
Healthcare is looking for experienced and motivated Accounts
Receivable Collection experts to join our dynamic team! The AR
Collection role is a full-time position responsible for collection
processes for TDD services that includes contract analysis,
reimbursement, denial management, appeals and resolving
billing-related issues with insurance companies or other
responsible party for services rendered.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.AIS Healthcare offers 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/work from home opportunity, growth, and
more!EDUCATION AND EXPERIENCE:
- A high school diploma or general education degree (GED)
equivalent is required.
- 3-5 years of healthcare industry experience required.
- 3-5 years of medical billing and collections experience
- Home Infusion, Intrathecal Pain Management experience
preferred.ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Recognizes patients' rights and responsibilities and supports
them in the performance of job duties, respects patient's rights to
privacy and confidentiality.
- 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
- Identifies any overpayments and/or duplicate payments and
investigates and resolves accordingly.
- Processes refund requests, in accordance with policies and
- Maintains contact with other departments to obtain patient or
insurance information needed for claim payment.
- Responsible for understanding all procedures within regulatory
- Ensures that the activities of the collection operations are
conducted in a manner that is consistent with overall department
protocol, and are following Federal, State, and payer regulation,
guidelines, and requirements.
- Verifies billing accounts with accounts receivable ledger to
ensure that all payments are accounted for and properly
- Makes calls to troubleshoot payment discrepancies and establish
- Documents, in detail, phone calls, phone number, person spoken
to, and call details on a consistent basis.
- Consistently looks for areas to maximize claim
- Resolves issues that created a denial within 5 days of receipt
- Maintains strictest confidentiality; adheres to all HIPAA
- 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.
- Shares knowledge gained with other staff members and works as a
- Interacts with others in a positive, respectful, and
- Performs other job-related duties as assigned.QUALIFICATION
- 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
- 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
- Ability to deal with highly sensitive and confidential
material, strong knowledge of HIPAA privacy guidelines and
- Competence with ICD-9 and ICD-10.
- Knowledge of medical terminology.
- Ability to assist in leading a diverse department in an
environment with frequent changes and priorities.
- 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 train employees, to include organizing,
prioritizing, and scheduling work assignments to meet timelines.
- 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
- Tolerant of frequent interruptions and distractions from staff
and other internal support teams.
- Proficient in Microsoft Office, including Outlook, Word, and
Excel.Steps to Apply:To apply for this role, you must complete a
Culture Index Assessment to be considered. Please note that your
application will not be considered if the Assessment is not
completed.Copy and paste the following link into your browser and
press enter. Then, select the corresponding position for which you
are applying. (Only one assessment per candidate is required.) The
assessment is brief, taking less than ten minutes to
HealthCare--- is the leading provider of advanced sterile,
patient-specific intrathecal pump medications and in-home
intravenous infusion, including immune globulin therapies. These
services, combines with your advanced nursing and care coordination
solutions, assist physicians and hospitals in delivering a superior
level of care for optimal therapeutic outcomes.We offer a wonderful
work culture, looking for an impact player who is positive,
earnest, and hardworking.
Keywords: AIS Healthcare, Jackson , BCBS AR / Collections Specialist, Accounting, Auditing , Ridgeland, Mississippi
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