Medical Billing Representative

Our client has become a leader in infusion therapy services. Administered by specially trained infusion nurses, these services are provided at standalone locations, physicians’ offices, or in the home of the patient. Each location provides individualized care in a private setting for procedures including IVIG, Hemophilia, Chemotherapy, TPN, and Pain Management.

Position Overview:

The Billing Representative is responsible for submitting the claims to insurance companies for payment to the provider for services rendered.

Duties include but are not limited to:

1. Perform all duties relating to Accounts payable and Receivable.
2. Verifies all client data for completeness and accuracy prior to billing cycle.
3. Maintain and updates vendor file.
4. Initiates and maintains all CMN’s
5. Receives and resolves patient calls concerning billing questions
6. Notify patients of any co pays/financial responsibilities as accurate as possible.
7. Maintain and release all ship-verified claims from adjudication review within three days.
8. Analyze and verify all dates of service and billed amounts.
9. Send out all claims with corresponding documentation within seven days from releasing.
10. Gains a detailed knowledge of all job functions, and all reimbursement policies and procedures.
11. Pulls appropriate documentation from client files for all generated claim forms.
12. Maintains the billing hold report for all claims that are un-billable.
13. Completes account contractual adjustment at the time of billing on all specified carriers through the delivery tickets.
14. Performs all other adjustments in a timely manner to reconcile accounts.
15. Completes the unbilled reconciliation weekly.
16. Post all payments received and reconcile with EOB received.
17. Assumes additional billing responsibilities as workloads dictate to meet departmental goals.
18. Generates all patients’ invoices as needed, and follows up with patients on outstanding invoices.
19. Scan all delivery tickets, and financial documents within the patients chart.
20. Maintains work area in a clean, neat and orderly fashion.
21. Projects a positive and professional image
22. Customer Service - Follows up on complaints, questions, and concerns that come to the department; responds to customer needs in a timely and efficient manner.
23. Develops and promotes teamwork and cooperation among fellow employees and managers.
24. Shows an appropriate sense of urgency in completing work and addressing the needs of others.

Requirements:

• High School Diploma or equivalent
• Medical Billing certification (preferred)
• A minimum of 3 to 4 years’ experience in Specialty Pharmacy and/or Infusion Pharmacy medication billing with a working knowledge of managed care, commercial insurance, Medicare, and Medicaid reimbursement. Home Infusion billing and/or Collections experience a plus.

Job Type: Full-time