The Home Infusion Reimbursement/Biller shall be responsible for creating and reviewing transactions (reimbursement billing) for accuracy and completeness; assisting with intake and insurance verification processes; obtaining necessary documentation; submitting and transmitting or printing claims for all 3rd party payers; posting payments; addressing claims rejections; managing accounts receivable; and participating in quality assurance processes.
The job expectations are as follows:
-
Verify insurance to ensure proper reimbursement.
-
Correctly determine drug quantities, pricing and qualification for infusion therapies.
-
Obtain necessary documentation, including physician orders, certificates of medical necessity, delivery records, and others.
-
Create and review transactions (reimbursement billing) for accuracy and completeness.
-
Submit and transmit or print claim forms for all 3rd party payer sources.
-
Obtain electronic remittance notices from third party payers as required.
-
Post payments received to the correct accounts.
-
Address claims rejections in a timely manner and in accordance with established policy.
-
Manage accounts receivable appropriately and in accordance with established policy.
-
Conduct collection activities in accordance with established policy.
-
Participate in quality assurance processes as necessary.
-
All other duties as required by the supervisor.
Physical Requirements/Environmental Conditions
-
Light lifting – up to 50 lbs. maximum.
-
Reaching and handling – extending hands and arms, working with hands.
-
Verbal communication – expressing or exchanging ideas through spoken word in person, via telephone and internet.
-
Auditory – perceiving sounds in person and telephonically.
-
Vision – obtaining impressions visually of the shape, size, distance, motion, color, or other characteristics of objects.
-
Exposure to the following environmental conditions:
-
Inside-protection from weather conditions, but not necessarily from temperature changes. Employee spends majority of time inside.
Qualifications
-
Must be at least 18 years old.
-
Must possess a minimum high school diploma.
-
Must be able to work independently and with minimal supervision.
-
Must have basic knowledge of computer software applications.
-
Knowledge of medical terminology and basic anatomy and physiology desirable.
-
Excellent mathematical skills required
-
Medical billing experience required
-
Infusion billing experience preferred
IND1