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Company Name : Axiva Health Solutions
Location : Havertown, PA
Position : Insurance Follow-up Specialist
Job Description : Are you a problem solver and high-performance professional who loves a challenge? Do you like to find unique and innovative solutions to challenges? Our growing healthcare business is looking for an exceptional home infusion billing expert to be a valued part of our team.Essential duties and responsibilities: · Billing and collections including deep knowledge and experience billing and collecting major medical claims for home infusion, ambulatory infusion, and/or specialty pharmacy.Responsible for medical billing and collections of IVIG, Biologics and Hemophilia claims in addition to other company specific therapies on CPR+ platform·Efficiently utilizes all functions of the company’s software(CPR+) applications, including maintaining accurate and detailed charts and notes.Reviews and navigates patient accounts and delivery ticketsCreates and accepts claims from clearing houses and work claim rejectionsEnsures receipt and validity of all documents needed to prepare and submit all billing and claims accurately.Responsible to understand prior authorization numbers, date spans, and HCPC unit calculations.Completes and submits all necessary insurance forms and electronic claims to process them in accordance to the timely filing requirements set by all third-party payors.Provides all necessary documentation required to expedite payments. This includes, but not limited to, demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physiciansCoordinates with inter-departmental associates to obtain appropriate documentation as needed for billing.Communicates with supervisor on a daily and/or weekly basis regarding any outstanding claims issues related to system, authorizations, wrong pay plans, nursing notes.Conducts frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers as needed.· Verifies that payments received are correct and according to company’s fee schedules, and that claims are processed correctly against billing and industry standards and regulations and match our contract agreements with individual providers.· Follows up on reimbursement research and communications and required appeals in an efficient and timely manner.· Customer service including conducting frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and some patients.· Research proper billing policies and procedures of all payors to ensure correct billing of claims.· Completes and submits all necessary insurance forms and electronic claims to process them in accordance with the timely filing requirements set by all third-party payors· Other duties as assigned.Schedule: This position is full-time.Qualifications: Home Infusion/Pharmacy Billing and/or Follow Up experience (2+ years)Wellsky/CareTend/CPR+(Software platform) experience (2+ years preferred)Medical terminology (1+ years),High school graduate required; some college preferred.Covid 19 vaccine – fully vaccinated- RequiredSkills needed: Reliable. Professional, friendly, energetic, and outgoing.Able to listen and offer suggestions.Problem solverHighly organized and detail oriented.Strong communication and interpersonal skills.Intermediate proficiency with Microsoft Suite. Ability to learn new software.High level of self-motivation and excellent time management skills required.Benefits: Benefits available.Job Type: Full-timePay:Benefits:401(k)401(k) matchingDental insuranceFlexible spending accountHealth insuranceLife insurancePaid time offVision insuranceSchedule:Monday to FridayJob Type: Full-timePay: From $23.00 per hourBenefits:401(k)401(k) matchingDental insuranceEmployee assistance programFlexible spending accountHealth insuranceLife insurancePaid time offVision insuranceSchedule:Monday to FridayApplication Question(s):1- Do you have knowledge of medical terminology (required) ?2- Do you have at least 2 plus years of related billing or follow up experience (Required) ?3- Do you have at least 2 plus years Wellsky/CareTend/CPR+ software experience (required)?4- Do you have healthcare business environment experience (preferred)? ,5- Are you fully vaccinated against Covid19 ( required)?6- Are you proficient in Microsoft products, including Word, Excel, PowerPoint?Work Location: Multiple Locations
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