Medical Collections Specialist

Job Description

Job Description

Come join an exciting and innovative company that puts the “care” back in healthcare!

Why do Medical Collections Specialists want to work here? The reason people love working for KabaFusion is because of the impact we have on our patients. Here, it doesn’t matter what your role is, you will be part of a team that works collaboratively to change lives. You will go home knowing that you have made a difference.

About us :

What started as a single pharmacy in 2010 has grown into KabaFusion becoming the largest privately held home infusion company in the country. We have a national network of pharmacies and nursing offices strategically placed to service 40+ states. Couple that with over 30 years of combined experience and it’s no wonder KabaFusion is the industry leader in home infusion.

About the role :

As a Medical Collections Specialist, you are responsible for managing and resolving outstanding patient accounts and insurance claims. This involves contacting insurance companies to collect payments, verifying billing information, and ensuring compliance with healthcare regulations.

Please note, this position is fully onsite at our office located in Lexington, MA. We offer The Grid shuttle bus service between the MBTA Alewife Station and our Lexington office.

Essential Duties & Responsibilities :

• Ensure all collections processes comply with regulatory requirements for government, commercial health plans, and medical group payors.
• Oversee accurate and timely billing, confirm correct coding and unit documentation based on payor and therapy type.
• Verify all payor-specific requirements are met before submitting claims electronically.
• Resolve claim issues by conducting timely follow-ups utilizing payor remittance advice and correspondence.
• Confirm required authorizations and medical documentation are included with claim submissions as well as appeals.
• Ensure claims are processed and reimbursed fully in accordance with contractual agreements.
• Accurately book revenue in alignment with managed care contracts.
• Conduct collections calls to payors and / or patients promptly and professionally.
• Maintain HIPAA compliance and safeguard patient health information in accordance with company policy.
• Responsible for achieving daily productivity targets and support timely completion of monthly financial deadlines.

As a Medical Collections Specialist, you bring :

Our Benefits :

KabaFusion is a mission driven company with a focus on innovation and patient care so, as a healthcare professional, if that sounds like something you want to be a part of, then look no further.