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Insurance Claims Specialist - Lexington, United States - KabaFusion
Description
Come join an exciting and innovative company that puts the care back in healthcareWHY KABAFUSION?
KabaFusion is a home infusion company with a national network of pharmacist owned pharmacies with the ability to service 40+ states.
Where KabaFusion truly excels, is in its approach to patient care and positive clinical outcomes.
With our dedicated and highly skilled clinical staff and in-house nursing with 24 hour on-call service; we are well equipped to care for our patients.
What we offer:
Competitive compensation
Benefits start on your 1st day of employment
401K w/ 4% Match no waiting or vesting period
PTO / Floating Holidays / Paid Holidays
Company Paid Life Insurance, STD, LTD
3 Employee Assistance Programs (EAP)
Learning & Development Programs
Perks includes discounts on travel, cell phone, clothing, and more
Employee Referral Program
Experience what being a part of the KabaFusion family feels like
JOB SUMMARY:
The Collections Analyst is responsible for the accurate resubmission of unpaid claims and the collection of payment of those claims according to the payors guidelines.
DUTIES &RESPONSIBILITIES:
Analyze and rectify claims issues with payers by timely follow up of claim status/payment.
Reviews and assures claims are processed and paid in full according to contractual agreements.
Ensures revenue is booked according to appropriate contract allowable.
Communicates with branches and other departments to assure resolution of reimbursement issues.
Communicates and addresses reimbursement issues with management for resolution in a timely manner.
Handles collections calls promptly with professionalism to payers and/or patients.
Must be able to prioritize, multi-task, meet goals and deadlines.
Protects patient health information by following regulations for HIPAA compliance.
Ensures daily productivity is met and monthly and monthly closing goals are met.
Meet and Maintain Cash Collection Goals and Metrics on a daily and monthly basis.
Timely Review of Remittance Advice/Correspondence; take appropriate steps to appeal non-payment of claims.
Utilize payer websites as resources to manage claim status and resolution.
Report to Manager on any reimbursement issues resulting in non-payment.
PREFERRED SKILLS &
EXPERIENCE:
Strong understanding of insurance terms, medical terminology, pricing methodologies for commercial and government billing requirements.
Knowledge and understanding of HCPC and CPT codes
High School Diploma or equivalent education.
Minimum 1 year of experience collecting from payors (health plans, medical groups and pharmacy benefits managers)
#corporate #kabafusion #nowhiring
