Lead Collections Specialist Overland Park, Kansas

Bio Matrix is a nationwide, independently-owned infusion pharmacy with decades of experience supporting patients on specialty medication. Our compassionate care team helps patients navigate the often-challenging healthcare environment. We treat our patients like family and get them started on therapy quickly. We work closely with them as well as their family and their healthcare providers throughout the patient journey, staying focused on optimal clinical outcomes.

At Bio Matrix the heart of our Inclusion, Diversity, Equity, & Access (IDEA) philosophy is the commitment to cultivate a welcoming space where everyone’s contributions are acknowledged and celebrated. Our goal is to draw in, develop, engage, and retain talented, high-performing individuals from diverse backgrounds and viewpoints. We believe that both respecting and embracing diversity enriches the experiences and successes of our patients, employees, and partners.

Monday Through Friday Between 8 am Central Standard Time & 5:00pm Central Standard Time

It is anticipated that an incumbent in this role is onsite in Overland Park, KS, may consider hybrid after 6 months of evaluation.

The Lead Collections Specialist serves in a lead capacity to assist the RCM Collections Manager with the training and support of the Collections Specialists. They are responsible for claims submission follow-up for correct and timely payment to achieve low delinquent payer balances and for efficient management of the assigned collections/reimbursement. This position monitors collections activity, develops corrective action to resolve deficiencies, assists team members with difficult accounts, ensures compliance with all legal and regulatory requirements, and resolves customer inquiries in a timely, professional manner.

• 5-7 years’ experience in high-volume pharmacy/infusion billing and collections, preferred.
• High School Diploma or equivalent.
• Understanding of basic medical terminology.
• Understanding and knowledge of revenue cycle, insurance billing and collections, Medicare, Medicaid, 3rd party payors.
• Knowledge of coding ICD-10, HCPCS, CPT, HER preferred.
• Understanding insurance audits and other external actions that impact revenue.
• Maintains strictest confidentiality of patient information in compliance with HIPAA and state and federal regulations.
• Strong verbal and written communication skills to individuals and business at all different education levels.
• Advanced computer skills and knowledge of office software packages. MS Office (Excel, Word).

• CPR+ experience not required, but a bonus.

• Assist by providing adequate resources and training for new employees.
• Support team members daily with problematic accounts.
• Provide clear and compelling direction to team members.
• Conduct collection calls and/or correspondence to payers for status of submitted claims.
• Review EOBs for correct payment, denials, zero and short pays or additional information required to process claims.
• Submit secondary claims, appeals for denials or short pays, appeal letters, claims review forms.
• Submit a "CIF" (Claim Inquiry Form) for Medicaid such as California, or other states required forms.
• Accountable for reducing delinquency for assigned accounts and reducing bad debt.
• Monitor overall company aging and payor specific trends reporting.
• Identify, report and respond to over payment requests and recoupments.
• Establish and maintain effective and cooperative working relationships with payors.
• Enlist the efforts of sales and senior management when necessary to accelerate the collection process.
• Utilize billing system to manage and update claims status.
• Communicate and follow up with billing regarding customer accounts discrepancies and billing procedures.
• Weekly/Monthly reporting to direct supervisor, management as requested.
• Perform other assigned tasks and duties as necessary to support the Accounts Receivable Department.

• Ability to prioritize and handle multiple tasks and projects concurrently.
• Must have scheduling…