Job description

Summary
Altus Biologics is dedicated to Treating Each Patient Like Family through its management of the administrative aspects of our physician’s biologic therapy practices. Our clinical professionals and administration staff are experienced and achieve desired results. We have a team environment that is filled with motivated, hard-working, and joyful employees ready to help our physicians and patients. Altus Biologics fosters opportunities for development and would like to provide you a real chance to make a difference.

Hybrid Schedule: 3 Days in Office, 2 Days Remote

Duties and Responsibilities

• Responsible for collection efforts on accounts receivable as assigned by the Revenue Cycle Director. Responsible for claim progress by using every available avenue, such as online tools, automated systems, and payor representatives.
• Maintain timely and accurate documentation on the patient account to reflect the current status of the claim.
• Responsible for analysis of Explanation of Benefits for zero pay and/or denied charges. Complete required research for disposition, i.e. claim correction, all levels of disputes, or adjustments.
• Prepare appeals to the payor specifications, i.e. dispute forms and/or any documentation for dispute and copy of patient’s medical record to support medical necessity denials. Coordinates all activity for claim corrections through the patient account system, electronic billing system, payor websites, as appropriate to the payer.
• Responsible for analysis of Aged Trial Balances for assigned payors. Ensures that every account has been worked through resolution.
• Responsible for incoming phone calls related to assigned payors by providing exceptional customer service and follow up. Possess good interpersonal skills.
• Communicate all payer issues, denial patterns, or other payment delays to the RCM Leadership team. Assist in determining appropriate action to move outstanding claims to final adjudication.
• Responsible for reviewing/monitoring payor websites, CMS website, Dept of Insurance (specific to region), and all available avenues for any changes/updates that affect the billing and/or patient account process related to assigned payors. Inform Revenue Cycle Leadership of changes to initiate implementation of system/process updates.
• All other duties as assigned

Qualifications

• High School Diploma or GED.
• 3-5 years of previous Healthcare business office experience preferred

Altus Biologics provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting and hiring.

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