Revenue Cycle Specialist - Pharmacy Biller

divh2Revenue Cycle Specialist - Pharmacy Biller/h2pInfuCare Rx is a leading home infusion provider accredited by URAC and ACHC offering a specialized approach to caring for patients in need of IV therapy and specialty pharmacy services in the homecare setting. We have created an ethical, team oriented, and quality work environment for our employees that cultivates achievement and success./ppAs a Revenue Cycle Specialist - Pharmacy Biller, youll 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. With InfuCare Rx experiencing rapid growth, youll 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./ppCandidates 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./ppResponsibilities and Duties:/pulliPrepare and submit clean claims to assigned insurance companies, either electronically or by paper./liliFollow up on all unpaid claims in a timely manner and prepare appeal or corrected claims to ensure payment./liliClaims Submission to Medicare: preparing and submitting claims to Medicare using the appropriate coding and documentation./liliStaying updated on Medicare regulations and policies to ensure compliance for billing./liliInteracting with management, patients, and Medicare representatives to resolve issues./liliReview EOBs and act appropriately./liliTimely Receivables-Revenue Management and reporting./liliSubmit write-off requests; identify bad debt as necessary./liliIdentify all roadblocks which potentially could delay claims payment and be ready to discuss solutions with management./liliBill payor plus patient responsibility amounts accurately and in a timely manner./liliHandle phone interaction with patients and insurance companies regarding billing and statement questions./liliInterpret Contracts/Maintain Payor customer service relationships in order to produce accurate claims, validate reimbursement, and keep A/R to company standards./liliProvide excellent customer service./liliOther duties as assigned/li/ulpSkills/Abilities/Work Experience:/pulliMust have home infusion experience/liliMinimum of 5 years in Medicare billing required/liliStrong knowledge of government insurance plans, managed care plans, HMO/PPOs, and patient billing/liliExperience with claims adjudication and calling insurance on rejected pharmacy claims/liliExperience with interaction with pharmacist and intake department to resolve claims rejections/liliAccurate and detail-oriented including ability to work under pressure./liliExperience with Microsoft Office (Word/Excel)./liliCommunicates clearly and effectively in both oral and written communications./liliProven problem-solving and critical thinking skills./liliHands-on experience with a computerized billing system./liliExperience with CPR+ Infusion Pharmacy software for billing highly preferred./liliAbility to self-motivate and effectively solve complex problems through internal/external interaction./liliKnowledgeable in Medicare and Medicaid guidelines for home infusion therapy./liliKnowledge of infusion billing for commercial and Medicaid payers./liliWorking knowledge of infusion CPT, HCPCS and ICD-10 codes./liliElectronic claim filing/liliMedical Billing compliance proficiency/li/ulpPhysical Demands:/ppRequired 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./ppInfuCare Rx is an equal opportunity employer. All employment decisions are made without regard to race, color, religion, national origin, military status, marital status, citizenship/immigration status, sex (including pregnancy and relation conditions, sexual orientation, or gender identity), age (40 and older), disability, genetic information (including employer requests for, or purchase use, or disclosure of genetic tests, genetic services, or family medical history), retaliation for filing a charge, reasonably opposing discrimination, or participating in a discrimination lawsuit, investigation, or proceeding. Background checks and drug screens are part of our hiring process. Affirmative Action/Equal Opportunity Employer, Minority/Female/Disabled/Veteran./p/div