Medical Billing Specialist

POSITION DESCRIPTION

*Home Infusion Pharmacy experience required*

Apex Infusion is looking for experienced and motivated Accounts Receivable Billing and collection specialist to join our dynamic team!

The Billing and collection Specialist is responsible for a broad range of billing processes related to managing the Ready to Bill unbilled revenue. The Billing Specialist will proactively work with assigned payer billing to maximize accurate and timely payment. Responsible for contract analysis, reimbursement, denial management, appeals and resolving billing-related issues with insurance companies or other responsible party for services rendered. Medicare/DME/Home Infusion billing experience preferred.

Major Responsibilities:

· Manages the Ready to Bill queue daily; performs QA to insure accurate and timely creation of new claims and generic invoices; insures submitted claims meet payer guidelines.

· Ensures daily accomplishments work towards company goals for cash collections and A/R over 90 days, Ready to Bill under 14 days, weekly and month-end close processes, and other departmental goals as outlined.

· Strong skills and knowledge in collections and timely follow ups with insurance companies for positive outcome is highly recommended.

· Processes confirmed tickets in “unworked” status within 48 hours of confirmation date; assigns an appropriate status to ensure proper handling by branch and billing personnel; makes necessary demographic changes to reduce rejections of submitted electronic and paper claims.

· Works “resolved” unbilled tickets within 24 hours to “ready” or next status for resolution.

· Conducts billing utilizing the most efficient resources to secure timely payment of open claims or invoices; electronic solutions should be given priority.

· Identifies patterns of non-compliance by branch staff in completing patient registration, supporting billing documentation, and delivery tickets.

· Reviews delivery tickets for accuracy and completes claims per payer-specific guidelines.

· If applicable, submit secondary billing in a timely manner with appropriate supporting documentation per payer-specific guidelines to ensure expected revenue is allowed.

· Research websites of assigned payers to bill for payer updates and share updates accordingly.

· Works within specified deadlines and stressful situations.

· Works overtime when necessary to meet department goals and objectives.

· Performs other tasks or special projects as assigned.

Education/Experience:

· High School Diploma or equivalent (GED) required.

· Excellent interpersonal, communication and organizational skills required.

· Ability to prioritize, problem solve, and multitask is required.

· A minimum of 1–2 years’ experience in Medical Billing (preferably home infusion) with a working knowledge of managed care, commercial insurance, and Medicare reimbursement preferred

Job Type: Full-time

Pay: $28.00 - $40.00 per hour

Benefits:

• Health insurance
• Paid time off

Schedule:

• 8 hour shift

Experience:

• Home Infusion Pharmacy: 1 year (Preferred)

Work Location: In person