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Revenue Cycle Specialist

Infucare Rx Inc on behalf of itself and its subsidiaries

Revenue Cycle Specialist

Fairfield, NJ
Full Time
Paid
  • Responsibilities

    Job Description

    OVERVIEW

    Enhance your infusion billing career with InfuCare Rx, a national Specialty Infusion Company. 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 to also investigate irregularities and resolve 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. With InfuCare Rx experiencing rapid growth, you'll join a fluid and evolving environment that will challenge your ability to adapt but will also reward you with ample opportunities while streamlining and improving processes.

    REVENUE CYCLE SPECIALIST

    Candidates will be considered who have at least 2 years of infusion billing experience, 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.

    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
    • Verify benefits and obtain authorization
    • 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

    • Minimum of 5 years in infusion medical billing required
    • Strong knowledge of government insurance plans, managed care plans, HMO/PPO’s, 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

    Physical Demands:

    Required to stand, walk, sit, talk and hear; required to use hands to operate vehicles and office equipment; must be able to occasionally lift and/or move up to 25 lbs; specific vision requirements for this job include: close, distance and peripheral vision, and the ability to adjust focus, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position without compromising patient care. 

    InfuCare Rx is an equal opportunity employer.  All employment decisions are made without regard to age, color, race, ancestry, national origin, disability, genetic information, military status, religion, creed, sex, pregnancy, childbirth, marital status, citizenship, sexual orientation, gender identity, gender expression, legally protected medical condition, or any other basis prohibited by applicable law.  Background checks and drug screens are part of our hiring process.  Affirmative Action/Equal Opportunity Employer, Minority/Female/Disabled/Veteran.