Job Description:
Prosper Infusion is a home infusion pharmacy looking for talented and motivated AR & Collections Specialist to join our dynamic team! The AR & Collections Specialist is responsible for a broad range of billing processes related to paid and unpaid claims. Responsible for contract analysis, reimbursement, denial management, appeals and resolving billing-related issues with insurance companies or other responsible party for services rendered. Commercial, Medicare, FL Medicaid, and Home Infusion billing experience preferred.
Major Responsibilities:
Ensures daily accomplishments work towards company goals for cash collections and A/R over 90 days, Ready to Bill under 14 days, weekly and month-end close processes, and other departmental goals as outlined.
Strong skills and knowledge in collections and timely follow ups with insurance companies for positive outcome is highly recommended.
Processes unpaid claims quickly to ensure proper handling by branch and billing personnel; makes necessary demographic changes to reduce rejections of submitted electronic and paper claims.
Identifies patterns of non-compliance by branch staff in completing patient registration, supporting billing documentation, and delivery tickets.
If applicable, submit secondary billing in a timely manner with appropriate supporting documentation per payer-specific guidelines to ensure expected revenue is allowed.
Works within specified deadlines and stressful situations.
Works overtime when necessary to meet department goals and objectives.
Performs other tasks or special projects as assigned.
Education/Experience:
High School Diploma or equivalent (GED) required.
College degree preferred in accounting or business.
Excellent interpersonal, communication and organizational skills required.
Ability to prioritize, problem solve, and multitask is required.
A minimum of 1–2 years’ experience in Home Infusion Pharmacy billing and collections, with a working knowledge of managed care, commercial insurance, and Medicare reimbursement preferred.
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