Accounts Receivable Specialist
Description
Onco360 - Louisville, KY
Our Onco360 Corporate Office in Louisville, Kentucky has an immediate need for an Accounts Receivable Specialist.
- Work directly with the insurance company, healthcare provider, and patient to get claims processed and paid appropriately; including Redetermination, and Appeals process.
- Be familiar with and be able to interpret both Rx Pharmacy and Medical claims and Remittance Advices. Understanding of HCPC, ICD-10, and/or Medication NDC in conjunction with claim billing activity.
- Have a working knowledge of electronic claim adjudication, familiar with NDPDP D.0 standard and rejections. Able to complete claim updates and corrections as needed.
- Well versed on Medicare and Medicaid pharmacy program and reimbursement guidelines.
- Monitoring electronic remittance and manual payments/denials to ensure proper payment posting and reflection of receivables. Coordinate with cash team to ensure pending payment postings are accounted for properly and resolved timely.
- Monitor A/R Dashboard and system A/R Manager to determine aged accounts that require follow up and prioritize the activities with the staff. Exhibit excellent time management skills in monitoring and following up on assigned aged claims.
- Serve as a resource for Patients on all Billing and Accounts Receivable inquiries, including but not limited to understanding of copay structure, accepting patient payments, and the like.
- Perform other tasks as assigned by Manager, Director and/or Executive leadership.
- Exhibit a positive, courteous, respectful, and helpful attitude towards patients, team members, payers, and management.
- Work within specified deadlines and open to overtime when necessary to meet department goals and objectives.
- Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
- Ability to demonstrate leadership and constructively work with and supervise others
- Required: High School Diploma or GED
- Desired: Certified Pharmacy Technician, Associates or Bachelor's Degree
- Required: 2-3 years Healthcare Accounts Receivable
- Desired: Pharmacy Specific Receivables preferred
- Required: NDC Medication Billing, PBM and Medical Contract, Medicare programs and Coordination of Benefits, Healthcare Audit Experience
- Desired: National of State Pharmacy Tech Certification
- Required: Deadline Oriented, Time Management, Prioritization Skills, Independent worker