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CSI Pharmacy

Revenue Cycle Collector

Career Insights for Medical Claims Processor / Representative

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What they do

A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.

$45,636 / year median in Texas

-1% projected decline

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Job Description

Revenue Cycle Collector CSI Pharmacy•3.5 Plano, TX Job Details Full-time $25•$27 an hour 2 hours ago Qualifications Appeals Regulatory compliance in claims processing High school diploma or GED Medical insurance appeals management Insurance claims appeal handling Full Job Description At CSI Pharmacy (CSI) , we are on a mission to provide Specialty Pharmacy services to patients with chronic and rare illnesses in need of complex care. CSI is a rapidly growing national Specialty Pharmacy. Whether you work directly with patients or behind the scenes in support of the business and its employees, you will use your expertise, experience, and skills to support our patients and our mission. Summary Accounts Receivable/Collections duties include ensuring accurate and timely collection of accounts receivable. Monitor incoming payments to ensure that our patients' pharmacy and medical services are processed promptly by insurance payers. The Revenue Cycle Collector must comply with established policies and procedures .
Compensation Range :
$25•$27/hr (DOE)
Schedule :
(On-Site) Monday•Friday, 8:30am•5:00pm
Location :
5340 Legacy Dr. Plano, TX Essential Duties and Responsibilities Include the following. Other duties may be assigned, as necessary. Follow up on outstanding medical claims with insurance companies, patients, and healthcare providers. Work with insurance companies to resolve disputes and facilitate payment. Communicate with insurance companies to resolve billing and payment issues. Maintain detailed electronic records and notes of all patient and payer communication. Resolve denied claims and appeals. Initiate requests for adjustments to revenue with supporting documentation where appropriate. Accurately interpret an explanation of benefits. Process refund requests from payers accurately and timely. Ensure that all claims are processed following industry regulations and standards. Adhere to all HIPAA guidelines/regulations. Performs other related duties as assigned or requested. Qualification Requirements To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions. Ability to work effectively with colleagues as team members and to communicate effectively. Possess the ability to multi-task and frequently change direction. Time management skills. Strong knowledge of infusion medical billing codes, insurance contracts, and regulations. Familiarity with pharmacy/infusion insurance claims and appeal process. Strong attention to detail and problem-solving skills. Experience with home infusion and/or specialty pharmacy. Experience with CareTend preferred Education and/or Experience High School Diploma/GED College degree preferred or equivalent experience. 1-3 years experience in infusion medical billing and/or collections.
NOTICE:
Successful completion of a drug screen prior to employment is part of our background process, which includes medical and recreational marijuana. By supplying your phone number, you agree to receive communication via phone or text. By submitting your application, you are confirming that you are legally authorized to work in the United States. JR# JR257795