Infusion Reimbursement Specialist

Job Description:

• Ensure receipt and validity of all documents needed to prepare and submit billing and claims accurately.
• Understand benefits verification and prior authorization, date spans, and HCPC unit calculations.
• Submit insurance claims accurately and on time to government, non-government, and third-party payors.
• Research claim denials and resolve associated accounts receivable in a timely manner.
• Conduct frequent phone contact with provider representatives, third-party customer service representatives, pharmacy staff, and case managers as needed.
• Provide, submit, and coordinate necessary documentation to comply with payor requirements.
• Collaborate with internal teams, communicate with external parties, and exchange information with other business services as needed.

Requirements:

• High school diploma or GED
• Deep knowledge and experience billing and collecting major medical claims for home infusion, ambulatory infusion, and/or specialty pharmacy.
• Two (2)+ years directly related Infusion and DME experience preferred.
• Experience using Bright Tree, CPR+, CareTend, or WeInfuse software.
• General knowledge of HCPCS, NDC, CPT, and ICD-10 coding.
• Ability to demonstrate a clear understanding of CMS 1500 and 837 claim formatting and billing process.

Benefits:

• Health Insurance
• Gap Insurance
• Dental Insurance
• Vision Insurance
• Short Term / Long Term Disability (company paid)
• Term Life Insurance (company paid, employee can elect additional)
• Full suite of CHUBB supplemental insurance plans, including: Disability Income, Level Term Life, Accident Insurance, & Critical Illness Insurance
• Floating holidays and paid time off
• Pre-Paid Legal
• 401K with company match