MEDICAL COLLECTIONS/BILLER SPECIALIST

Location : Nationwide | Company LUXCORE MD

About Us

Luxcore MD is a dynamic and innovative pharmaceutical/ physician dispensing company dedicated to improving healthcare outcomes and enhancing patient access to medications in a single visit. We’re on a mission to expand our market presence and impact, and we’re seeking a passionate and results-driven Pharmacy Business Development Manager to join our team.

Job Description

Luxcore MD employee must be trained medical collector/biller on Rx, Work Compensation, PIP and taught strategies on how to persuade adjusters, attorneys and debtors to pay entire balance or set up payment arrangements on medical bills. Be able to correspond with major healthcare insurance groups and other major payers regarding reimbursement on Rx billing claims, while applying strict state jurisdictions. Be able to work on reducing aged account receivable by 75 percent and manage and collect delinquent patient accounts within required time frames..

Key Responsibilities

  • Collect on 90 days medical accounts or older.
  • Contact insurance companies to check eligibility and confirm claim status to ensure timely payment.
  • Partner with attorneys to gain status information on claims and bankruptcy details.
  • Answer inbound calls from debtors and initiate outbound calls to negotiate and follow-up on payment arrangements.
  • Complete a total of 100 calls/contacts or more per day to successfully meet and/or exceed established quotas.
  • Execute a variety of documents including letters and emails in draft and final form for distribution to internal team members and external clients.
  • Negotiate settlements.
  • Track delinquencies and create statistical spreadsheets to keep management updated on status of accounts.
  • Analyze customer’s financial position for credit recommendations.
  • Assist with reviews and audited complex problematic accounts.
  • Maintain follow up with payers in a stratified manner.
  • Assist the section manager and perform all designated duties in the absence of the section manager.
  • Maintain records in an organized manner, correct and re-billed denied claims when necessary, and performed secondary billing.
  • Maintain patient information and updated it on system
  • Worked with debtors to establish payment plans
  • Prepared accounts for legal review when unsuccessful in reaching an agreement with debtors
  • Worked with attorneys and insurance companies on resolving delinquent accounts that where related to automobile accidents, workers comp, etc.
  • Ensured medical collection activity was conducted as per company, federal and state guidelines
  • Exceeded daily quota of 250 calls daily
  • Exceed Monthly goal
  • Analyze managed care contractual issues, provided feedback to the Credentialing Department.
  • Apply provider payments on accounts, applying contractual managed care reimbursement rates.
  • Relentlessly submitted written appeals to payers, on denied claims for adjudication and resolution. Successfully overturning numerous insurance’s decisions.

Qualifications

  • Education: College or equivalent. Successful completion of program in medical billing; current Certified Medical Reimbursement Specialist (CMRS) certification; or Associates Degree in Business Administration, Accounting or Health Care Administration may be preferred or required.
  • Training and experience: Unless otherwise indicated, five years of current experience within the last three years in a comparable job classification required.
  • Internet, email, MS Office and data entry skills required.
  • Educated on and compliant with HIPAA regulations; maintains strict confidentiality of patient and client information.
  • Ability to work effectively within role independently and with other team members.
  • Ability to organize and complete work in a timely manner.
  • Ability to read, write and effectively communicate in English.
  • Ability to understand medical/surgical terminology.
  • Health Requirements: In good health and able to work without restrictions as evidenced by Health Statement.
  • Physical Demands-Stooping, turning, bending, squatting, kneeling and the ability to lift up to 50 pounds; constant/repetitive standing; requires normal, correctable vision and hearing, and the ability to accurately discern color as necessary to perform job functions.
  • Legal compliance
  • Documentation skills
  • Accounts receivable and payable skills
  • Experience with medical billing software
  • EOB, ODG knowledge
  • Knowledge of multiple insurance plans, including Work Comp, PIP
  • Organization and attention to detail
  • Excellent phone skills
  • Exceptional negotiation skills
  • Ability to work in a high-pressure environment

Why Luxcore MD?

  • Competitive salary and benefits package.
  • Opportunity to make a real impact in the pharmaceutical industry.
  • Collaborative and innovative work environment.
  • Career growth and development opportunities.
  • Join a company committed to improving healthcare and patient outcomes.

If you’re ready to take your career to the next level and play a key role in shaping the future of pharmaceutical business development, we want to hear from you. Apply now by sending your resume and a cover letter outlining your relevant experience and accomplishments to info@luxcoremd.com

Luxcore MD is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Luxcore MD thanks all applicants for their interest. Only those selected for an interview will be contacted.