- Provide primary customer support to patients and their families.- Counseled patients and their families on payment options and arranged installment agreements. - Analyze and reconciles accounts to ensure accuracy of payment and credits.- Collaborate with the pharmacy team to resolve any disputes and maintain relationships with the facilities & patients. - Handle phone-calls regarding questions on an outstanding accounts. Including payments, breakdown of their copays, etc. Resolving customer inquiries and disputes relating to their account in a professional and timely manner. - Assist processing payments and applying to customer balances. - Assist in depositing ACH-checks from patients to be applied to their accounts. - Uploading delinquent accounts to our Transworld system (TSI) account to continue debt collection. - Creating monthly invoices for patients for their medications & uploading the invoices to our payment portal for online payments. - Collaborate with the team to streamline the collections process and improve efficiency. - Assisting in developing new collection procedures to ensure compliance and maximize recovery. - Training new hire collections specialist on best practices and company policies. - Programs: SAGE (Accpac), FrameworkLTC, FrameworkECM, TSI Collections

COVID Clinic - Reviewing NYSIIS and CIR to see if residents and staff members have been vaccinated - Entering vaccinations into each system once the resident or staff member has been vaccinated & the signed consents forms are completed - Enrolling uninsured patients and staff into HRSA for reimbursement of the vaccine administration fees - Billing the correct insurance (Part B or commercial or NYS Medicaid) with the correct HCPT code for reimbursement - Conducting insurance eligibility verification to maximize reimbursement potential - Keeping up to date on any changes in the covid vaccine provided federally & booster eligibility changes that may occur. - Staying abreast of industry changes concerning Covid-19Problems Department - Assist in checking EMR systems to find any missing information on prescription orders- Assist in updating our records so that we have all current information to fill the medications in a timely manner - Double checking EMR systems to make sure that all the requirements are entered for orders pertaining to wound care- Double checking EMR systems to make sure that there are not therapeutic duplications- Double checking EMR systems to make sure the facilities are prescribing medications that are covered Monthly Analysis - Assist in creating a monthly analysis of each long-term care facilities usage of medications and offer interchanges based on cost - Creating a monthly analysis of billing data to identify opportunities for cost optimization and revenue enhancementsPricing Department - Assist in pricing out medications for facilities for any tentative admissions- Run test claims on-site to obtain a valid claim response and determine optimal reimbursement

Overseeing the facility billing department onsite and overseas with any issues or updates regarding billing prescription medications for residents at long-term care facilities. Assisting the director of billing with as projects that they may need help on. Managing multiple long-term care facilities with any billing inquiries for their residents at their facility. Handling any inquiries from facilities regarding their bill and medication costs. Reach out to insurance companies regarding any prescription rejections, or any new processing information that may be need to process prescriptions for residents. Investigating and resolving denied claims in a timely manner to ensure quick adjudication. Ensuring that they patient's medical information is accurate and up-to-date. Identifying the billing data provided regarding each patient to determine whether to bill the insurance or the facility accordingly. Creating monthly bills for the facility that includes a breakdown of prescriptions for all residents in each long-term care facility. Preparing and submitting billing data, documents, and finalized invoices that are due to the facility in a timely manner. Ability to check NYS EMedNY website to confirm a doctors enrollment into the NYS Medicaid program and checking to see if a resident is covered under NYS Medicaid via EPACES. Ability to check Connecticut HUSKY Medicaid to find coverage for a resident. Responsible for assisting HR in payroll for the billing department. Handling any time adjustments and approving overtime for the billing department. Responsible for entering all the PTO's and write ups.Responsible for hiring, training, and disciplining and supervising the facility billing staff.

Team leader for the facility billing department. Handling all billing inquiries related to medications dispensed while a patient is in a long-term care facility. Includes reaching out to insurance companies and dealing with the Medicaid Department. Assisting billing specialist with problems they may come across while handling their facilities.

Daily roles include all details a patient entering a long-term care facility. With the start of their billing and admission process. Admissions includes checking every resident that comes in has the correct insurance for their medication. Verifying the daily census which involves any admissions, discharges, stat changes that occur within the day. Billing process includes keeping an eye out for pending Medicaid and Medicaid patients via the NY Medicaid website. It also includes private paying patients - verifying that their insurance is correctly processed so that no extra fees incur on the patient. Status changes in a patient is very common that it must be kept updates as soon as it is verified. Dealing with insurance rejections and hospice plans so that the patient may get their medications for what they deserve.

Responsible for sending & re-sending patient statements for their medications.Reaching out to the patient or whomever is the financial responsibility caretaker regarding their statements. Assisting in answering any questions they may have regarding their bill. Processing their payments via credit card or check. Re-billing claims and investigating any patients' concern regarding their prescriptions. Reaching out to patients who have not made payments to make sure their information on file is correct. Placing people on collections via transworld. Processing payments from insurance companies for medications. Creating and sending out Best Available Evidence reports to insurance companies for any existing balances for patients with LIS 3 level NYS medicaid. Ability to check EPACES for medicaid status for patients who are not fully LIS 3 levels. Reaching out to facilities regarding a patient's medicaid application status and update their profile into FrameworkAssisting in basic patient care needs in regards to their prescriptions.

- Provide primary customer support to patients and their families.- Counseled patients and their families on payment options and arranged installment agreements. - Analyze and reconciles accounts to ensure accuracy of payment and credits.- Collaborate with the pharmacy team to resolve any disputes and maintain relationships with the facilities & patients. - Handle phone-calls regarding questions on an outstanding accounts. Including payments, breakdown of their copays, etc. Resolving customer inquiries and disputes relating to their account in a professional and timely manner. - Assist processing payments and applying to customer balances. - Assist in depositing ACH-checks from patients to be applied to their accounts. - Uploading delinquent accounts to our Transworld system (TSI) account to continue debt collection. - Creating monthly invoices for patients for their medications & uploading the invoices to our payment portal for online payments. - Collaborate with the team to streamline the collections process and improve efficiency. - Assisting in developing new collection procedures to ensure compliance and maximize recovery. - Training new hire collections specialist on best practices and company policies. - Programs: SAGE (Accpac), FrameworkLTC, FrameworkECM, TSI Collections