Revenue Cycle Specialist

4 weeks ago


Fairfield, New Jersey, United States Infucare Rx Inc on behalf of itself and its subsidiaries Full time
Job Title: Revenue Cycle Specialist

InfuCare Rx Inc on behalf of itself and its subsidiaries is seeking a skilled Revenue Cycle Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for managing the reimbursement process for our infusion pharmacy services.

Key Responsibilities:
  • Prepare and submit clean claims to insurance companies, either electronically or by paper.
  • Follow up on unpaid claims in a timely manner and prepare appeal or corrected claims to ensure payment.
  • Manage claims submission to Medicare, including preparing and submitting claims using the appropriate coding and documentation.
  • Stay up-to-date on Medicare regulations and policies to ensure compliance for billing.
  • Interact with management, patients, and Medicare representatives to resolve issues.
  • Review Explanation of Benefits (EOBs) and take appropriate action.
  • Manage timely receivables and revenue management, including reporting.
  • Submit write-off requests and identify bad debt as necessary.
  • Identify and resolve potential roadblocks that may delay claims payment.
  • Bill payor and patient responsibility amounts accurately and in a timely manner.
  • Handle phone interactions with patients and insurance companies regarding billing and statement questions.
  • Interpret contracts and maintain payor customer service relationships to produce accurate claims, validate reimbursement, and maintain accounts receivable to company standards.
  • Provide excellent customer service.
Requirements:
  • Minimum of 5 years of experience in Medicare billing.
  • Strong knowledge of government insurance plans, managed care plans, HMO/PPOs, and patient billing.
  • Accurate and detail-oriented, with the ability to work under pressure.
  • Experience with Microsoft Office (Word/Excel).
  • Excellent communication and problem-solving skills.
  • Hands-on experience with a computerized billing system.
  • Experience with CPR+ Infusion Pharmacy software for billing is 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.

InfuCare Rx Inc on behalf of itself and its subsidiaries 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.

Click here to view our Drug Testing Policy

https://infucarerx.com/wp-content/uploads/2024/08/Drug-Testing-Policy-for-Texas-Applicants_08072024.pdf



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