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. Job Type: Full-time Pay: $22.00 - $28.00 per hour Expected hours: 40 per week 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). Benefits: • 401(k) • 401(k) matching • Dental insurance • Employee assistance program • Flexible spending account • Health insurance • Paid time off • Vision insurance Application Question(s): Have you used the software CPR+ or CareTend at any of your previous employers? Education: High school or equivalent (Required) 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) Language: English (Required) Shift availability: Day Shift (Required) Work Location: Bellingham or Federal Way locations, based on employee’s state of residence; remote exceptions may apply. Apply tot his job