Reimbursement - Payor Collections

Company: KabaFusion
Location: Cerritos
Posted on: May 7, 2022

Job Description:

KabaFusion is a home infusion company with exceptional employees!
KabaFusion is a home infusion company with a national footprint. We opened our first pharmacy in 2010 in Southern California and now have 21 pharmacies in 15 states with a focus on IVIg, SCIg, acute infusion, and nutritional therapies.
Our success is the result of teamwork from our dedicated staff who truly believe in putting the "care" back in healthcare. A career at KabaFusion means joining a team that lives by its values and empowers team members to make a difference!
What we offer:
Competitive compensation
Benefits start on your 1 st day of employment
401K w/ 4% Match - no waiting or vesting period
PTO / Floating Holidays / Paid Holidays
Company Paid Life Insurance
3 Employee Assistance Programs (EAP)
Emerging Leaders Training Program
Perks--- includes discounts on travel, cell phone, clothing, and more---
Employee Referral Program
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 payor's 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)

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PI175251757

Keywords: KabaFusion, Cerritos , Reimbursement - Payor Collections, Accounting, Auditing , Cerritos, California