Collections Specialist (RCM) Hybrid - Coney Island, NY

About the position

The Collections Specialist in Revenue Cycle Management (RCM) at Vivo Infusion is a vital role responsible for ensuring the timely follow-up on unpaid or underpaid claims with insurance payers. This position plays a crucial part in identifying and resolving claim issues that adversely affect the revenue cycle process. The Collections Specialist will coordinate, reconcile, and manage claim denials to achieve resolution effectively. The role requires a proactive approach to initiate collection follow-ups on all unpaid or denied claims, ensuring that all actions are documented in the practice management system in a consistent and concise manner. In addition to collections and payments, the specialist will be responsible for researching, appealing, and resolving claim rejections or denials with the appropriate payors. This includes reviewing payments to ensure the accuracy of insurance payments and patient balances, as well as facilitating drug manufacturer copay assistance programs for patient financial assistance. The role also involves responding to written communications from payors and communicating any payment trends or insurance denials that may impact revenue to management promptly. The Collections Specialist will maintain patient records and confidentiality via the electronic Medical Record System and correspond with patients regarding their insurance and payment responsibilities. The position requires meeting specific measurable goals (SMGs) and performing other duties as assigned, contributing to the overall efficiency and effectiveness of the revenue cycle management process.

Responsibilities
?? Initiate collection follow-up of all unpaid or denied claims with the appropriate payors.
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?? Research, appeal and resolve claim rejections/denials with the appropriate payor.
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?? Review payments to ensure accuracy of insurance payment and patient balances.
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?? Facilitate drug manufacturer copay assistance program for patient financial assistance.
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?? Respond to written Payor communications as indicated with appropriate action in a timely manner.
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?? Communicate payment trends or insurance denials that impact revenue to management in a timely manner.
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?? Document in the practice management system all follow up and communication on a patient account in a consistent and concise format.
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?? Correspond with patients regarding their insurance and payment responsibilities.
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?? Maintain patient records and confidentiality via the electronic Medical Record System.
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?? Meet Specific Measurable Goals (SMGs).
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?? Perform other duties as assigned.

Requirements
?? High school graduate or equivalent.
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?? Minimum 1-2 years of related prior work experience required, preferably in the healthcare industry.
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?? Proficient (intermediate level of application) with all Microsoft Office Products programs.
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?? Knowledge of insurance, accounting, medical billing, HIPAA, Medicare/Medicaid, medical abbreviations, and terminology, preferred.
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?? Ability to work effectively in a team environment and independently.
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?? Excellent interpersonal skills.
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?? Able to read, write, speak, understand, and satisfactorily communicate with others in English in person, over the phone and via email.

Nice-to-haves
?? Proven competencies can take precedence over prior work experience.

Benefits
?? Health insurance
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?? Dental insurance
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?? Tuition reimbursement
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?? Paid time off
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?? Vision insurance
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?? 401(k) matching
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?? Referral program

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