Reimbursement Specialist

About LUX Infusion At LUX Infusion, we’re reimagining infusion care to be more human, supportive, and connected. Inspired by lux—meaning light—we guide patients, providers, and partners through complex therapies with clarity, compassion, and confidence. As a clinician‑led, U.S‑based organization, we put people first—helping patients feel seen and supported through faster therapy starts, dedicated care coordination, and meaningful collaboration. Our commitment to inclusion, diversity, equity, and advancement (IDEA) is central to our culture, ensuring every team member feels valued and empowered to make a difference. Compensation Up to $27.00 Per Hour Based Upon Experience. Final compensation offer to candidate may vary based upon work experience, education, and/or skill level. BioMatrix pay range: $23–$27 USD. Schedule & Location 8:30 am – 5:00 pm CST or EST on site in Overland Park, KS or Garnet Valley, PA. Work location may change based on business needs. Job Description The Reimbursement Specialist is responsible for the accurate and timely billing and reimbursement of claims. Qualification Requirements High School Diploma or GED required Minimum of two (2) years of medical insurance experience required Basic computer and internet skills (e.g., Microsoft Office) Strong customer service skills, focus and dedication Commitment to excellent customer service and professionalism to resolve complex payer coverage issues Qualifications Preferred Minimum of two (2) years of home infusion experience preferred Prior experience with CPR+ and/or CareTend preferred Certified Pharmacy Technician license preferred, but not required Billing Responsibilities Submit accurate claims to primary and secondary insurers and resubmit corrected/rejected claims in a timely manner Acquire necessary authorizations and current eligibility information from insurance companies prior to dispense release; communicate findings with pharmacy; document notes in system Maintain patient files with pertinent information required by insurance companies Confirm orders have been delivered before submitting claims Invoice patients for patient responsibility amounts (co‑pay, deductible, out‑of‑pocket, etc.) Communicate with field staff as needed (new referrals, signed tickets) Responsible for billing audits both internally and externally Collections Responsibilities Track each claim weekly; maintain A‑R Manager report in Excel and update each outstanding claim with a status detail note, including insurance company’s reference number; submit report to the Director of Revenue Cycle Management; update claim’s billing note in CPR+ with the status detail note Predict cash flow from claim’s progress through insurance system Maintain documents showing proof of communication with insurance companies, providers, etc. Track incoming checks for receipt; if issued to patient, communicate with patient or RCC to collect monies Respond to insurance requests in a timely manner (medical records, prescriptions, CMNs, etc.) Make bank deposit and maintain accurate monthly deposit report, as needed Insurance Responsibilities Verify new patient referral information with insurance companies and report findings to the Director of Revenue Cycle Management via insurance verification form Complete insurance company contracts and/or necessary forms to maintain or become a provider Report unusual events or trends related to claims or insurance industry to the Director of Revenue Cycle Management Assist in insurance audits by providing all necessary billing paperwork in a timely manner Proactively improve understanding of bleeding disorders, products and treatments; stay current on legislative changes and insurance coverages, and disseminate this information to employees, patients and others within the bleeding disorder community Participate in QMC Quarterly Meetings, as needed Participate in orientation, education, training programs, CE’s, literature reviews and other materials, as assigned Complete all competence/skills billing assessments as required Provide courteous, cooperative and timely service to patients, visitors, and staff Participate in quality assurance activities and audits, as directed Knowledge, Skills & Abilities Requirements Maintain competence for current position Maintain accurate records and prepare reports and correspondence related to the work Perform work within specified time frames and adapt positively to frequent interruptions and changes in workload and/or work schedule Strong customer service skills, focus and dedication Excellent interpersonal and organizational skills Set priorities and solve problems Excellent verbal, written, and communication skills Respond quickly to emergency requests Self‑motivated, self‑reliant and team oriented Communication Skills Oral Communication – Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions; demonstrates group presentation skills; participates in meetings Written Communication – Writes clearly and informatively; edits work for spelling and grammar; varies writing style to meet needs; presents numerical data effectively; reads and interprets written information Computer Skills Become and remain proficient in all programs necessary for execution of the position Physical Demands The physical demands described here represent those required for an employee to successfully perform the essential functions of this role. Reasonable accommodations may be made to enable individuals with disabilities to perform these functions. Other Requirements Participate annually in required legal and ethical compliance training Consistently act in compliance with LUX Infusion’s legal, ethical, and compliance policies Adhere to all standards and procedures outlined in the LUX Infusion Compliance Manual Refrain from any behavior that could be considered unethical or unlawful Expectations for All Employees All LUX Infusion team members are expected to support the organization’s mission, vision, and values by demonstrating integrity, dedication, compassion, and enthusiasm. This includes placing patients first, working collaboratively with a “stacked‑hands” mindset, and maintaining a consistent focus on quality, accountability, and continuous improvement. General Information The statements above describe the general nature and level of work performed by individuals in this role. They are not intended to be an exhaustive list of all responsibilities, duties, and skills required. Contact Contact LUX Infusion Talent Team at View email address on click.appcast.io or View phone number on click.appcast.io. Equal Opportunity Employer LUX Infusion is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by law. #J-18808-Ljbffr BioMatrix Infusion Pharmacy