Qureos Mentor

OSO HOME CARE

<div><div>The Major Medical Collector is responsible for overseeing accounts receivable and collections for a home health agency and specialty pharmacy. This role ensures timely reimbursement from insurance payors, manages claim denials, and supports accurate financial operations. The Collector serves as a key liaison between the agency, pharmacy, patients, and payors, with a focus on compliance, accuracy, and efficiency in revenue cycle management</div><div><b>
QUALIFICATIONS:</b></div><ul><li>
Minimum 5 years of experience in medical collections, with specific knowledge of home health and/or specialty pharmacy billing.</li><li>
Strong understanding of Medicare, Medicaid, and commercial insurance payor processes.</li><li>
Experience with claim denials, appeals, and reimbursement procedures for home health services and specialty medications.</li><li>
Proficiency with medical billing systems, electronic health records (EHR), and pharmacy benefit systems. CPR +, (Mediware) and/or Caretend software is a plus</li><li>
Excellent organizational, analytical, and problem-solving skills.</li><li>
Strong communication skills with the ability to interact professionally with patients, payors, and internal staff.</li></ul><div></div><div><b><br>
RESPONSIBILITIES:</b></div><br>
<div></div><ul><li>
Review and reconcile Accounts Receivable (A/R) reports to track and manage outstanding balances.</li><li>
Participate in productivity calls to provide updates on collection status and goals.</li><li>
Submit appeals or correct claims assigned to payors, ensuring accuracy and compliance with home health and specialty pharmacy requirements.</li><li>
Answer incoming calls from patients, payors, and internal teams, addressing billing inquiries and claim issues.</li><li>
Follow up on appeals and corrected claims to secure resolution and payment.</li><li>
Prepare and maintain correspondence with assigned payors, documenting communication and progress.</li><li>
Conduct targeted collections efforts for specialty pharmacy claims, including high-cost medications and therapies.</li><li>
Conducts Job duties in accordance with established policies procedures and acceptable work standards of the industry.</li><li>
Actively participates in the Oso&rsquo;s process improvement program.</li></ul><div></div><div><b><br>
Core Competencies</b></div><ul><li><b>
Accuracy &amp; Compliance:</b> Ability to work with detailed billing requirements specific to home health and pharmacy services.</li><li><b>
Collections Expertise:</b> Skilled in follow-up, appeals, and negotiation with payors to minimize aging A/R.</li><li><b>
Patient-Centered Service:</b> Provide respectful and professional communication to patients and caregivers regarding billing inquiries.</li><li><b>
Collaboration:</b> Work effectively with clinical, pharmacy, and administrative teams to resolve issues impacting reimbursement.</li></ul><p></p><p><br>
Applicant and employee privacy policy can be found at https://osohomecare.com</p></div>

Major Medical Collector

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OSO HOME CARE

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Major Medical Collector