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Infusion Center Biller Specialist

2 months ago

Artesia, New Mexico, United States Jobot Full time
Job Title: Infusion Center Biller/Intake Specialist

About the Role:

We are seeking an experienced and detail-oriented Biller/Intake Specialist to join our team at Jobot. As a key member of our infusion center, you will be responsible for ensuring seamless patient onboarding, efficient billing processes, and optimal revenue cycle management.

Responsibilities:
  • Patient Intake and Insurance Verification:
    • Conduct comprehensive insurance verifications, including benefits investigation for infusion therapies
    • Obtain and manage prior authorizations for infusion treatments
    • Educate patients on insurance coverage, out-of-pocket costs, and financial assistance programs
  • Billing and Claims Management:
    • Process complex infusion therapy claims using appropriate coding
    • Manage drug wastage billing
    • Handle claim denials and appeals, particularly for high-cost specialty medications
    • Expertise in billing for both the drug and administration components of infusion therapy
  • Specialty Pharmacy Coordination:
    • Liaise with specialty pharmacies for medication procurement and billing
    • Manage split-billing scenarios for pharmacy-dispensed medications administered in the infusion center
  • Revenue Cycle Optimization:
    • Monitor key performance indicators (KPIs) such as clean claim rate, days in A/R, and denial rate
    • Implement strategies to reduce claim rejections and improve first-pass resolution rates
    • Stay updated on payer policies specific to infusion therapies and specialty medications
  • Compliance and Documentation:
    • Ensure compliance with Medicare and commercial payer guidelines for infusion billing
    • Maintain accurate and complete documentation to support medical necessity for infusion treatments
  • Patient Financial Counseling:
    • Provide clear explanations of infusion therapy costs and insurance coverage
    • Assist patients in navigating manufacturer assistance programs and copay support options
Requirements:
  • Bachelor's degree in healthcare administration, Medical Billing and Coding, or related field
  • 3+ years of experience in medical billing, with specific experience in infusion center or specialty pharmacy billing
  • In-depth knowledge of billing guidelines and specialty medication reimbursement
  • Proficiency in infusion center management software and electronic health record systems
  • Strong understanding of HCPCS Level II coding for drugs and biologicals
  • Familiarity with USP standards and their impact on billing practices

Why Work with Us:

We offer a competitive pay, great benefits package, PTO and paid-holidays off, and the opportunity to join a fast-growing company.