Home Infusion Billing Specialist

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

📋 Description

• Review home infusion charges, billing records, orders, authorizations, and supporting documentation for completeness and accuracy.

• Prepare and submit accurate claims to Medicare, Medicaid, and commercial payers.

• Bill for home infusion medications, supplies, administration services, and applicable per diem or related services.

• Apply HCPCS/CPT codes, units, modifiers, NDC information, place of service, and other claim elements.

• Validate drug quantities, dosage units, dates of service, and billing units.

• Identify and address missing or inconsistent information and coordinate corrections prior to submission.

• Review payer-specific billing guidelines, fee schedules, coverage requirements, and claim submission rules.

• Validate authorizations, referrals, and other payer requirements.

• Ensure accuracy of payer, member, provider, and service information.

• Review and resolve claim rejections and denials.

• Correct billing errors and resubmit claims when necessary.

• Research payer responses and denial codes.

• Communicate recurring denial trends and billing issues to the Billing Lead.

• Maintain precise billing notes and claim documentation.

• Perform billing quality checks and engage in internal billing audits.

• Adhere to billing SOPs, payer requirements, Revenue Cycle policies, and privacy regulations.

• Collaborate with Billing, Accounts Receivable, Authorization, Pharmacy, Operations, and other departments.

• Assist in enhancing billing workflow and increasing clean claim rates.

• Participate in training and process updates pertaining to home infusion billing and payer requirements.

⛳️ Requirements

• High school diploma or equivalent is required.

• A minimum of 2 years of home infusion billing experience is necessary.

• Experience billing Medicare, Medicaid, and commercial insurance plans is required.

• Prior experience using CareTEND for home infusion billing is mandatory.

• Familiarity with HCPCS/CPT coding, claim submission, payer guidelines, and denial resolution is essential.

• Working knowledge of medical billing processes and payer requirements, along with an understanding of home infusion billing practices.

• Strong attention to detail and the ability to identify discrepancies in billing information, units, charges, and claim data.

• Capability to manage multiple priorities and meet daily and monthly billing deadlines.

• Strong analytical and problem-solving skills, especially when researching payer denials and claim issues.

• Effective written and verbal communication skills, with the ability to collaborate across different departments.

• Ability to work independently in a remote setting while maintaining productivity, accuracy, and accountability.

• Proficiency in billing systems, payer portals, Microsoft Office, and other Revenue Cycle technology.

• Monday to Friday, 8 AM to 5 PM.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and career advancement.

• Supportive work environment with a focus on teamwork and collaboration.