Billing Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Assist Soleo Health's Specialty Infusion Pharmacy

• Primarily manage insurance and self-pay billing, excluding Medicare

• Submit both electronic and paper claims

• Follow up with clearinghouse vendors regarding accepted and outstanding rejections

• Prepare accurate medical claims for commercial, government, employer, and institutional payers

• Review claims pricing discrepancies based on updates or changes to the fee schedule

• Create and submit secondary electronic pharmacy and medical claims

• Bill manufacturer copays via portals or traditional paper billing

• Monitor billing requirements under payer contracts and government programs

• Address insurance and billing inquiries from branch staff and provide educational support

• Review electronic medical records to ensure the submission of clean claims

• Conduct monthly revenue reviews of billed claims

• Handle incoming calls and triage as necessary

• Generate claim batches and process electronic submissions

• Manually process claims not eligible for electronic billing

• Identify, rectify, and resubmit claims requiring attention

• Ensure coding specificity for optimal third-party reimbursement

• Review and follow up daily on unbilled delivery tickets

• Accurately document actions taken in patient accounts

• Collaborate with the pharmacy team to address PBM issues and guarantee timely billing

• Achieve performance goals through efficient use of time and resources

• Provide customer service to both internal and external clients

• Ensure compliance with government mandates, payer contracts, and company policies

• Communicate billing issues to Intake, collections, RBL, and management

• Monitor unbilled-pending invoice queues and relay missing information to branches

• Maintain up-to-date knowledge of departmental and organizational policies

⛳️ Requirements

• 2 years of experience in home infusion billing is required

• High School Diploma or equivalent

• Familiarity with HCPC coding and medical terminology

• Experience in providing customer service to both internal and external customers

• Proficiency in computer usage is essential

• Must be reliable

• Excellent communication skills via phone and email

• Working knowledge of ICD10, CPT, and NCCI; familiarity with modifier application and standard billing regulations is necessary

• Ability to work remotely (USA)

🏝️ Benefits

• Competitive Wages

• 401(k) with a Match

• Referral Bonus

• Paid Time Off

• Great Company Culture

• Annual Merit Based Increases

• No Weekends or Holidays

• Paid Parental Leave Options

• Affordable Medical, Dental, and Vision Insurance Plans

• Company Paid Disability and Basic Life Insurance

• HSA and FSA (including dependent care) Options

• Education Assistance Program

• Monday - Friday, 8:30am - 5pm