Reimbursement Specialist /Collectors (Multiple Roles, Beverly Hills & Laguna Hills, CA)

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    "description": "<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; font-weight: bold\">About AmeriPharma</span></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">AmeriPharma is a rapidly growing healthcare company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity. We like people who are passionate about their roles and people who like to grow and change as the company evolves.</span></p>\n<p><br></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; font-weight: bold\">AmeriPharma’s Benefits</span></p>\n<ul>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">Full benefits package including medical, dental, vision, life that fits your lifestyle and goals</span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">Great pay and general compensation structures</span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">Employee assistance program to assist with mental health, legal questions, financial counseling etc.</span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">Comprehensive PTO and sick leave options</span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">401k program</span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">Plenty of opportunities for growth and advancement</span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">Company sponsored outings and team-building events</span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">Casual Fridays</span><br></li>\n</ul>\n<p><br></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; font-weight: bold\">Job Summary</span><br></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\"><span style=\"color: rgb(72, 65, 63); text-decoration: none\">We are seeking </span><span style=\"text-decoration: none\">Reimbursement Specialists, from entry-level to experienced, </span><span style=\"color: rgb(72, 65, 63); text-decoration: none\">to join our dynamic team. The ideal candidate </span><span style=\"text-decoration: none\">will be responsible for ensuring accurate and timely collections to maximize reimbursement experience. This role is essential in ensuring accurate and timely collections and maximizing reimbursement through effective interactions with third-party payers, insurance plans, and patients. The candidate will possess strong analytical skills, be detail-oriented, and excel in submitting claims, appeals, and resolving discrepancies with minimal supervision.</span></span></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\"> </span></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; font-weight: bold\">Schedule Details</span></p>\n<ul>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">Location: On-Site (Beverly Hills or Laguna Hills, CA)</span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">Hours: Monday to Friday, 8am-4:30pm</span></li>\n</ul>\n<p><br><br></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; font-weight: bold\">Duties and Responsibilities</span></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\"><br></span><br></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\"><span style=\"color: rgb(31, 31, 31)\"><em><span style=\"font-weight: bold\">Entry-Level Reimbursement Specialists</span></em> provide essential support in managing patient accounts and ensuring the timely recovery of payments. The primary focus of this role is administrative support for Accounts Receivable (AR) management, including reviewing the patient inventory of assigned accounts</span><span style=\"color: rgb(31, 31, 31)\"> </span><span style=\"color: rgb(31, 31, 31)\">and collecting on open AR inventory to meet our goal of receiving reimbursements within 60 days of the billed date</span><span style=\"color: rgb(31, 31, 31)\">. </span><span style=\"color: rgb(31, 31, 31)\">Key responsibilities involve correlating insurance coverage with services to be provided, preparing and reviewing insurance claims</span><span style=\"color: rgb(31, 31, 31)\">, </span><span style=\"color: rgb(31, 31, 31)\">and ensuring that all Copay Assistant claims are billed promptly to the appropriate Foundation</span><span style=\"color: rgb(31, 31, 31)\">. </span><span style=\"color: rgb(31, 31, 31)\">This role involves general collections on patient balances</span><span style=\"color: rgb(31, 31, 31)\">, </span><span style=\"color: rgb(31, 31, 31)\">managing all assigned correspondence before due dates</span><span style=\"color: rgb(31, 31, 31)\">, </span><span style=\"color: rgb(31, 31, 31)\">and actively assisting in maintaining a positive Days Sales Outstanding (DSO) on the assigned account inventory</span><span style=\"color: rgb(31, 31, 31)\">.</span></span></p>\n<p><br><br></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; font-weight: bold\">Experienced Reimbursement Specialists </span></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\"><em><span style=\"font-weight: bold\">Self-directed Experienced Reimbursement Specialists </span></em>manage all aspects of the Accounts Receivable (AR) life cycle for assigned patient accounts. The primary objective is to maintain financial health by aggressively collecting on all open AR inventory and patient balances, ensuring that reimbursements are received within 60 days of the billed date and consistently maintaining a positive Days Sales Outstanding (DSO) on the assigned account inventory. This expert role involves correlating insurance coverage with services, preparing and reviewing complex insurance claims, and ensuring all Copay Assistant claims are billed in a timely manner to the appropriate Foundation.</span><br></p>\n<p><br><br></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; font-weight: bold\">The Work Includes</span></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">● Actively collecting on open AR to ensure payment within 60 days of billing, managing and responding to correspondences by their due dates, reviewing contracts and fee schedules for accurate reimbursement, and verifying insurance coverage alignment with services provided.</span></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">● Auditing open inventory, verifying and following up on insurance claims and accounts receivable, ensuring timely billing for Copay Assistant claims, collaborating with other departments for necessary documentation, and answering incoming calls.</span></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">● Submitting appeals and pursuing additional payments on any medical claims denied in error or paid less than the expected reasonable maximum allowable rate for the procedure codes submitted and level of patient’s benefit coverage</span><br><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">● Navigating complex insurance policies, ensuring the accuracy of received reimbursement payments, reviewing the accuracy of submitted claims, and communicating process inefficiencies or billing errors that lead to claim denials or underpayments to team members and management.</span></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">● Perform other duties assigned by management</span></p>\n<p><br></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; font-weight: bold\">Required Qualifications</span></p>\n<ul>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; text-decoration: none\">Ability to read, write, speak, and understand the English language fluently. </span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; text-decoration: none\">Ability to collaborate with other team members and management for all pharmacy needs. </span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; text-decoration: none\">Strong time management, communication, multitasking and organizational skills. </span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\"><span style=\"text-decoration: none\">High attention to detail and strong analytical and problem-solving skills.</span><span style=\"text-decoration: none\"><br></span></span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; text-decoration: none\">Ability to work collaboratively in a fast-paced team environment.</span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; text-decoration: none\">Ability to work independently and meet deadlines with minimal supervision.</span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; text-decoration: none\">Strong attention to detail with the ability to type accurately and analyze data.</span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; text-decoration: none\">Ability to apply logical thinking to solve complex and practical problems.</span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; text-decoration: none\">Flexible and able to work hours that ensure timely completion of projects and duties.</span><br></li>\n</ul>\n<p><br></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; font-weight: bold\">Education and Experience Requirements</span></p>\n<ul>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; text-decoration: none\">High School Diploma or equivalent.</span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; text-decoration: none\">Minimum of 1 year of hands-on experience in medical coding/billing with a working knowledge of managed care, commercial insurance, Medicare and Medicaid reimbursement required.</span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; text-decoration: none\">Experienced specialists will have in depth Knowledge of managed care, commercial insurance,  ICD-10, CPT, HCPC codes, J billing codes, and </span>\n<ul>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\"><span style=\"text-decoration: none\">medical terminology, along with CMS HCFA 1500 forms &amp; Electronic Billing, and </span><span style=\"text-decoration: none\">n-depth understanding of healthcare billing and coding processes.</span></span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; text-decoration: none\">Experience with Benefit Investigation and Patient Responsibility Agreements.</span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; text-decoration: none\">Experience with automated billing systems, CPR+ is preferred.</span></li>\n<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; text-decoration: none\">Advanced proficiency in Microsoft Word, Excel, and Outlook.</span><br></li>\n</ul>\n</li>\n</ul>\n<p><br></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; font-weight: bold\">AmeriPharma’s Mission Statement </span></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">Our goal is to achieve superior clinical and economic outcomes while maintaining the utmost compassion and care for our patients. It is our joint and individual responsibility daily to demonstrate to outpatients, prescribers, colleagues, and others that We Care!</span></p>\n<p><br></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; font-weight: bold\">Physical Requirements </span></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">The following physical activities described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions and expectations</span></p>\n<p><br></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt; font-weight: bold\">EEO Statement </span></p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt\">The above statements are intended to describe the work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required. The duties and responsibilities of this position are subject to change and other duties may be assigned or removed at any time. AmeriPharma values diversity in its workforce and is proud to be an AAP/EEO employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, sexual orientation, gender identity, national origin, age, protected veteran status, or on the basis of disability or any other legally protected class.</span></p>",
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