Home Infusion Reimbursement Specialist

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.

Candidate will:

• 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.

Skills:

• 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.

Application Question(s):

Have you used the software CPR+ or CareTend at any of your previous employers?

Education: High school or equivalent (Required)

Experience:

• Medical Billing: 2 years (Required)
• Home Infusion Billing software: 2 years (Required)
• Pharmacy or home infusion: 2 years (Required)
• Major Medical: 2 years (Required)
• Pharmacy Benefit Managers: 1 year (Preferred)

Job Type: Full-time

Pay: $22.00 - $28.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday
• Must be available to work full-time, from 9:00 AM to 5:00 PM Pacific Standard Time (PST).

Expected hours: 40 per week

Work Location: Remote