Home Infusion Reimbursement Specialist

🌍 Remote, USA 🎯 Full-time 🕐 Posted Recently

Job Description

Infusion Solutions is a fast growing locally-owned home infusion and specialty pharmacy based in Washington state. This is a remote home infusion reimbursement position. We provide an excellent benefit package, competitive wages, and a fast-paced, safe, work environment.

Ideal candidate for this position will have 2+ years of home infusion billing experience (1 year is required), have great customer service skills, the ability to learn/adapt and who are excellent problem solvers. They will have the ability to lead, own the process and be results oriented.

Prepare and submit clean claims to assigned insurance companies.
Have a thorough understanding of all payer contracts. Experience with Copay Assistance a plus.
Have experience in home infusion and specialty pharmacy billing
Bill all charges on a daily basis and ensure timely, accurate submission and collection of claims.
Ability to bill and collect on self-pay outstanding AR. Strong customer service experience with handling patient pay balance discussions.
Verify that services and products are correctly authorized and required documentation is on file.
Work toward accomplishing collaboratively set goals related to billing metrics.
Work all claim denials on a daily basis.
Follow up on all unpaid claims in a timely manner and prepare appeal or corrected claims to ensure payment.
Be proficient in payer appeals process for underpaid or denied claim invoices
Ability to verify Eligibility accurately via electronically and over the phone with the Payer at risk.
Review EOBs and act appropriately.
Timely Receivables-Revenue Management and Reporting
Interpret Contracts/Maintain Payer customer service relationships in order to produce accurate claims, validate reimbursement and keep A/R to company standards.
Provide excellent customer service.
Requirements:
Minimum of two (2) years of medical billing experience required.
Prior experience in Home Infusion Billing.
Experience with billing Major Medical claims.
Proficiency in CPR+ or CareTend systems is highly desirable.
Experience working with Pharmacy Benefit Managers (PBMs) is a significant advantage.
Prepare and submit clean claims to assigned insurance companies.
Have a thorough understanding of how to convert vials into units & vice versa per the payer’s fee schedule.
Understands how to submit and perform corrected claims via various clearinghouses.
Comprehends payer contracts and fee schedules, i.e., per diems, AWP’s, NDC#’s, etc.

Exceptional customer service skills.
Two (2) years of medical billing experience
Home Infusion Billing Experience
Strong knowledge of government insurance plans, managed care plans, HMO/PPOs and Patient Billing
Accurate and detail oriented including ability to work under pressure.
Experience with Microsoft Office Suite (Word/Excel)
Hands on experience with a computerized billing system.
Experience with CareTend Infusion Pharmacy software for billing highly preferred.
Ability to self-motivate and effectively solve complex problems through internal/external interactions.
Knowledgeable in Medicare and Medicaid guidelines for home infusion therapy
Knowledge of infusion billing for medical and commercial Medicaid payers.
Ability to deal with problems involving several variables in particular situations.
Professional demeanor to interact with clients, insurance companies and referral sources.

Job Type: Full-time

Pay: $22.00 - $28.00 per hour

Expected hours: 40 per week