Revenue Cycle Specialist - Billing
Infucare Rx Inc on behalf of itself and its subsidiaries
Summary
As a Revenue Cycle Specialist, you'll take charge of multiple facets of the pharmacy/infusion reimbursement process as you interact with insurance companies and patients to ensure accurate payment. You will have the experience of investigating irregularities and resolving problems when unforeseen roadblocks arise. This is a great opportunity for an experienced professional with a track record of filing claims, billing, appeals, reviews, customer service, problem resolution and overall revenue cycle management.
Job description
Responsibilities and Duties
- Prepare and submit clean claims to assigned insurance companies, either electronically or by paper.
- Follow up on all unpaid claims in a timely manner and prepare appeal or corrected claims to ensure payment.
- Claims Submission to Medicare: preparing and submitting claims to Medicare using the appropriate coding and documentation.
- Staying updated on Medicare regulations and policies to ensure compliance for billing.
- Interacting with management, patients, and Medicare representatives to resolve issues.
- Review EOBs and act appropriately.
- Timely Receivables-Revenue Management and reporting.
- Submit write-off requests; identify bad debt as necessary.
- Identify all roadblocks which potentially could delay claims payment and be ready to discuss solutions with management.
- Bill payor plus patient responsibility amounts accurately and in a timely manner.
- Handle phone interaction with patients and insurance companies regarding billing and statement questions.
- Interpret Contracts/Maintain Payor customer service relationships in order to produce accurate claims, validate reimbursement, and keep A/R to company standards.
- Provide excellent customer service.
- Other duties as assigned.
Skills/Abilities/Work Experience
- Must have Home infusion experience
- Minimum of 5 years in Medicare billing required
- 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 (Word/Excel).
- Communicates clearly and effectively in both oral and written communications.
- Proven problem-solving and critical thinking skills.
- Hands-on experience with a computerized billing system.
- Experience with CPR+ Infusion Pharmacy software for billing highly preferred.
- Ability to self-motivate and effectively solve complex problems through internal/external interaction.
- Knowledgeable in Medicare and Medicaid guidelines for home infusion therapy.
- Knowledge of infusion billing for commercial and Medicaid payers.
- Working knowledge of infusion CPT, HCPCS and ICD-10 codes.
- Electronic claim filing
- Medical Billing compliance proficiency
Requirements
- Must have Home infusion experience
- Minimum of 5 years in Medicare billing required
- 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 (Word/Excel)
- Communicates clearly and effectively in both oral and written communications
- Proven problem-solving and critical thinking skills
- Hands-on experience with a computerized billing system
- Experience with CPR+ Infusion Pharmacy software for billing highly preferred
- Ability to self-motivate and effectively solve complex problems through internal/external interaction
- Knowledgeable in Medicare and Medicaid guidelines for home infusion therapy
- Knowledge of infusion billing for commercial and Medicaid payers
- Working knowledge of infusion CPT, HCPCS and ICD-10 codes
- Electronic claim filing
- Medical Billing compliance proficiency
Benefits
- Medical, Dental & Vision
- Short Term Disability
- Long Term Disability
- Group Term Life
- Voluntary Life
- AD&D
- 401(k) Matching
- Paid Sick Leave
- Paid Time Off
- Paid Holidays
Company overview
Infucare Rx Inc is a specialized healthcare services company operating in the home health care sector. The company, along with its subsidiaries, focuses on providing pharmaceutical and medical care services to patients in their homes. As a home health care services provider, Infucare Rx likely offers medication management, infusion therapy, and other clinical services that enable patients to receive complex medical treatments outside of traditional hospital settings. The company's business model centers on delivering professional healthcare services directly to patients' residences, which can include administration of intravenous medications, monitoring of treatment responses, and coordination with physicians and other healthcare providers. This approach allows for more personalized care while potentially reducing healthcare costs associated with hospital stays. Infucare Rx operates in the growing home healthcare market, serving patients who require ongoing medical attention but prefer or need to receive treatment in familiar home environments. The company's services are particularly valuable for patients with chronic conditions requiring regular medication administration or those recovering from acute medical events who need continued professional care during their recovery period.