Reimbursement - Payor Collections

Company: KabaFusion
Location: Cerritos
Posted on: June 20, 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 1st 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 ProgramJOB 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)#corporate #collections #healthplan #medicalgroups #pbm #finance #reimbursement #kabafusion #nowhiring
      
      PI179446882

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