AR Claims Denial Clerk-Remote

<div><p><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><strong style="background-repeat: no-repeat;outline: none;font-weight: 600;color: rgb(51,51,51);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;">About Orsini Specialty Pharmacy&nbsp;</strong></span><br style="background-repeat: no-repeat;outline: none;color: rgb(51,51,51);font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="color: rgb(51,51,51);font-family: sans-serif , arial , helvetica;font-size: 11.0pt;font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;">Providing compassionate care since 1987, Orsini is a leader in rare disease and gene therapy pharmacy solutions, built to simplify how patients connect to advanced medicines. Through our comprehensive commercialization solutions including a nationwide specialty pharmacy, patient services hub, home infusion and nursing network, and third-party logistics provider, we work with biopharma, providers, and payors to ensure No Patient is Left Behind™.</span><br style="background-repeat: no-repeat;outline: none;color: rgb(51,51,51);font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="color: rgb(51,51,51);font-family: sans-serif , arial , helvetica;font-size: 11.0pt;font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;">&nbsp;</span><br style="background-repeat: no-repeat;outline: none;color: rgb(51,51,51);font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><strong style="background-repeat: no-repeat;outline: none;font-weight: 600;color: rgb(51,51,51);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;">Our Mission&nbsp;</strong></span><br style="background-repeat: no-repeat;outline: none;color: rgb(51,51,51);font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="color: rgb(51,51,51);font-family: sans-serif , arial , helvetica;font-size: 11.0pt;font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;">Orsini is on a mission to be the essential partner for biopharma innovators, healthcare providers, and payers to support patients and their families in accessing revolutionary treatments for rare diseases. Through our integrated portfolio of services, we seek to pioneer comprehensive solutions that simplify how patients connect to advanced therapies while providing holistic, compassionate care so that No Patient is Left Behind™. &nbsp;</span><br style="background-repeat: no-repeat;outline: none;color: rgb(51,51,51);font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="color: rgb(51,51,51);font-family: sans-serif , arial , helvetica;font-size: 11.0pt;font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;">&nbsp;</span><br style="background-repeat: no-repeat;outline: none;color: rgb(51,51,51);font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><strong style="background-repeat: no-repeat;outline: none;font-weight: 600;color: rgb(51,51,51);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;">LIVE IT Values&nbsp;</strong></span><br style="background-repeat: no-repeat;outline: none;color: rgb(51,51,51);font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="color: rgb(51,51,51);font-family: sans-serif , arial , helvetica;font-size: 11.0pt;font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;">At the heart of our company culture, the Orsini LIVE IT core values serve as guiding principles that shape how we interact with each other and those we serve. These values are the driving force behind our commitment to excellence, collaboration, and genuine care in every aspect of our work. &nbsp;</span><br style="background-repeat: no-repeat;outline: none;color: rgb(51,51,51);font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="color: rgb(51,51,51);font-family: sans-serif , arial , helvetica;font-size: 11.0pt;font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;">&nbsp;</span><br style="background-repeat: no-repeat;outline: none;color: rgb(51,51,51);font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><strong style="background-repeat: no-repeat;outline: none;font-weight: 600;color: rgb(51,51,51);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;">Leading Quality, Integrity, Valued Partner, Empathy, Innovation, Team-First&nbsp;</strong></span></p></div><p><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><strong>POSITION SUMMARY</strong></span></p><p><span style="color: rgb(51,51,51);font-family: sans-serif , arial , helvetica;font-size: 11.0pt;font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><strong>Salary Range</strong>: $22-$25 <span style="color: rgb(51,51,51);font-style: normal;font-weight: 400;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;">Hourly</span></span></p><p><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">The Claims Denial Clerk is responsible obtaining status of claims once they age beyond a specified time range. The claims clerk will submit simple documentation requested by payors to get claims paid. The CDC will work with the Collection manager, billing team and auditor on denials that require a higher level of attention such as appeals, grievances rebills etc. The CDC will check and advise BV team when claims deny for eligibility issues. The claims denial clerk will assist with a any other duty assigned as needed.</span><br><br><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><strong>REQUIRED KNOWLEDGE, SKILLS &amp; TRAINING</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">Minimum 1 year of experience in patient accounts, BV and/or collections preferably specialty pharmacy</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">Familiar with AR and operational health care systems</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;">Experience with Microsoft applications. (Excel, Word, PowerPoint, etc)</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">Familiar with medical terminology</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">Experience with billing</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">Able to multitask and utilize excel in a fast-paced working environment</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">Able to problem solve and assist coworkers through the thought process of solving problems</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">Collaborate on best practices for efficiency and streamlines communication throughout teams</span></li></ul><p><br><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><strong>ESSENTIAL JOB DUTIES</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">Provide claim status on outstanding claims</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">Research denials takes necessary action to resolve requests</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">Utilizes the most efficient resources to resolve denials quickly</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">Identifies short payments, over payments, unpaid claims, and resolves accordingly. Reviews residual balances after payments are applied and generates necessary adjustments, overpayment notification, refund requests</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">Work with copay assistance plan to obtain eligibility to determine if patient was active during the DOS that we are billing&nbsp;</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">Work with copay assistance plan to confirm that funds are still available initiate transfer</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">Communicate with the PCC Team when patients are no longer active with the copay assistance plan</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">Ability to work remotely</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-size: 11.0pt;font-family: sans-serif , arial , helvetica;">Ability to be flexible and assist with other projects when needed.</span></li></ul><p><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><strong>EMPLOYEE BENEFITS</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;">BCBSL Medical</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;">Delta Dental</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;">EyeMed Vision</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;">401k</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;">Accident &amp; Critical Illness</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;">Life Insurance</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;">PTO, Holiday Pay, and Floating Holidays</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 11.0pt;">Tuition Reimbursement</span></li></ul>