BrightSpring Health Services

Goal oriented individual who consistently follows up on unpaid claims utilizing AlphaCollector and filing appeals when appropriate to obtain maximum reimbursement.

• Process manual billing for various DSS/CSA Localities in Virginia, verifying to Purchase Orders/Invoices received.
• Analyze claims for assigned payor sources and follow up on all outstanding claims.
• Good phone skills are essential, as this person will have to call the various Localities throughout each month regarding past due claims, Purchase Orders, etc., to ensure timely payments.
• Provide any additional research for claims designated on the critical accounts list, input comments prior to monthly Critical Account call.
• Rebill claims for any outstanding AR that is collectible. Provide detail comments in AlphaCollector, including payment date if applicable. Field questions throughout the month regarding revenue and aging issues.
• Maintain open communication.
• Process cash transfer & check requests to processor
• Timely follow up on denied items/unpaid claims, to ensure claims are processed within the Fiscal Year for Virginia.
• Reading and interpreting various Purchase Orders received, sign and return to each payor as necessary.
• Respond to inquiries from various Localities regarding invoices/payments.
• Regularly attend monthly staff meetings and continuing educational sessions as requested.
• Perform additional duties as requested by Supervisor or Management team.
Measurement: DSO, accounts worked per month (productivity), AR>30 days, cash collections @ 98% or higher of prior month revenue.

Experience: At least 2 years billing Virginia DSS/CSA Localities, private insurance and/or federally funded programs, researching agings and claims preferred. Experience in reading and understanding remits (explanation of benefits) for denial reasons. Understanding of medical terminology and ability to research various payor inquiries.
• Computer experience is essential, including, but not limited to: Excel, practice management software, word processing and spreadsheet applications.
• Strong Organizational skills.
• Must be able to work independently or in a team environment.
• Excellent customer service skills.
• Strong written and verbal communication skills.
• Ability to manage relationships with various Government payers.
• Responsible use of confidential information and HIPAA policies.
• Perform to company standards of compliance with policies and procedures.
• Ability to multi-task and work courteously and respectfully with fellow employees, clients and patients.
• Must have strong/professional communication skills (email and phone).
• Must understand conditions of payment.
• Must have strong Microsoft Excel skills.
• Experience with State billing portals preferred.
Education: Minimum High School diploma or equivalent, associate degree or higher preferred

BrightSpring Health Services provides complementary and integrated home- and community-based pharmacy and health solutions for complex populations in need of specialized and/or chronic care. Through the Company’s service lines, including pharmacy, home health care and primary care, and rehabilitation and behavioral health, we provide comprehensive care and clinical solutions in all 50 states to over 400,000 customers, clients and patients daily. For more information, visit www.brightspringhealth.com. Follow us on Facebook, Twitter and LinkedIn.

USD $19.00 - $25.00 / Hour