Specialty Pharmacy Biller
Job Description
DeliverIt Infusion & Specialty is a closed-door infusion & specialty pharmacy that positions patients at the core of our uniquely tailored approach to patient care.
DeliverIt Infusion & Specialty is searching for a Specialty Billing Specialist to assist in our infusion, specialty, and nursing service billing.
Thank you in advance for looking at the list of responsibilities and qualifications.
We look forward to reviewing your resume!
**Benefits:**
* **$1,000 signing bonus after the first 6 months of employment.**
* **$2,000 signing bonus after the first 12 months of employment.**
* Competitive pay & benefits.
* Positive environment with a strong and supportive team.
* Opportunities to train and mentor within the billing fields of Infusion & Specialty.
* Company offers H1B sponsorships.
**Essential Roles & Responsibilities:**
* Processing electronic claims accurately, timely, and being persistent with aging accounts.
* Transferring paid claims to secondary insurance carriers, copay assistance programs either electronically, through their online portal, or digital fax.
* Processing denials and secondaries promptly, including claim reconsiderations and case openings.
* Submitting appropriate documentation for adjustments to supervisor.
* Working on aging accounts daily to strive for all outstanding claims being paid within 90 days.
* Aggressively working to ensure prompt payments for claims older than 90 days.
* Performing successful medical insurance, CMS, and PBM audits with positive outcomes.
* Assisting month-end closings as scheduled, to assure timeliness.
* Working collaboratively with other departments, including intake, nursing, and billing, to improve timely reimbursement process and results.
* Adhering to those performance programs, policies, procedures, guidelines, and internal control standards established to guide the operation of the company.
* Daily monitoring of outstanding accounts and claims.
* Identifying outstanding accounts receivable, including hospital LOA’s, Single Case Agreements with insurance companies, house accounts, and inner company invoices.
* Being proactive in contacting patient accounts to encourage timely payments as well as setting up patient payment plans.
* Processing credit card payments and refunds.
* Resolving billing issues with payors.
* Submitting requested information from payors through their portal to ensure prompt payments of outstanding claims.
* Resolving customer credit issues.
* Processing all medical records requests in a timely manner.
* Preparing and presenting reports on collection activities and progress of unpaid claims in weekly or monthly A/R meeting with management.
* Notifying the supervisor of problem accounts.
* Performing other duties as assigned.
**Qualifications:**
* Having a billing & coding certificate is strongly recommended.
* Working knowledge of medical terminology.
* Knowledge of HCPCS, ICD-10, and NDC coding.
* Knowledge of electronic billing.
* Experience with working on open claims in Change, Availity, and other online Insurance Portals.
* Experience dealing with insurance rejections, reconciliations, and high dollar patient accounts.
* Excellent calculation/math skills.
* Ability to understand insurance contracts for billing purposes.
* Ability to prioritize and handle multiple tasks and projects concurrently.
* Strong interpersonal and communication skills and the ability to work effectively with branch departments.
* Demonstrated knowledge and proficiency in the principles, procedures, and best practices related to this position.
* Proficient level of software proficiency in using PC software to support activities, especially Microsoft Office, Excel, Teams, Word, and WhatsApp.
* The ability to work with confidential material and maintain confidentiality is required along with sensitivity to employees and customers needs and data while adhering to HIPAA compliance.
* Strong attention to detail is a must.
* Proficient analytical skills are a must.
* Accounting experience is preferred.
* Experience as a Pharmacy Technician is preferred.
* Experience with CareTend and/or CPR+ software is preferred.
**Proficiency in any of the following languages is encouraged, but not required:**
Spanish
Job Type: Full-time
Pay: From $22.00 per hour
Expected hours: 40 per week
Benefits:
* 401(k)
* Dental insurance
* Disability insurance
* Employee discount
* Flexible schedule
* Health insurance
* Life insurance
* Paid time off
* Vision insurance
Schedule:
* 8 hour shift
* Monday to Friday
Education:
* Associate (Preferred)
Experience:
* HCPCS: 1 year (Preferred)
* NDC: 1 year (Preferred)
* ICD-10: 1 year (Preferred)
* Microsoft Office: 1 year (Preferred)
* High dollar medical accounts: 1 year (Preferred)
* Medical billing: 1 year (Preferred)
* Caretend and/or CPR+ software: 1 year (Preferred)
License/Certification:
* Billing and Coding Certificate (Preferred)
Ability to Relocate:
* Sugar Land, TX 77478: Relocate before starting work (Required)
Work Location: In person
