Billing Specialist

BioMatrix Specialty Pharm•Syracuse, NY

6d•Hybrid

About The Position

The Billing Specialist is responsible for verifying that all appropriate prescription reimbursement data has been obtained, entered into the system and is accurate weekly and prior to month end. Processes electronic pharmacy insurance claims to Medicare D, Medicaid, and Commercial Insurance. Assures the timely and accurate submission of invoices to the responsible payer for services and products provided, and evaluates payments received for final resolution and application to the patient account.

Requirements

GED or high school diploma required
Minimum of two (2) years of working experience in medical billing & collection related activities required
Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.
Basic level skill in Microsoft Office (including Word, Excel, PowerPoint, etc.).
Able to stay abreast of payer alerts and reimbursement changes.
Able to work in a fast-paced environment.
Able to navigate and interpret insurance contracts.
Ability to actively communicate, inspire and motivate all levels of staff.
Ability to think and act strategically and proactively.
Ability to maintain accurate records and prepare reports and correspondence related to the work.
Ability to organize and coordinate the work of others.
Ability to set priorities and assign work to other professionals.
Excellent analytical skill.

Nice To Haves

Minimum of five (5) years of working experience in medical billing & collection related activities preferred
Previous home infusion therapy billing experience preferred
Experience with CareTend or CPR+ preferred

Responsibilities

Prepare and submit insurance claims for home infusion services, including nursing, supplies, and medications.
Verify documentation of supplied products align with prepared claim.
Verify accuracy of billed codes and accuracy of billed and expected amounts.
Have a thorough understanding of payer contracts.
Understanding the different types of home infusion medications and therapies.
Knowledge of insurance verification and reimbursement processes.
Address customer inquiries and resolve billing discrepancies, providing excellent customer service to both internal and external stakeholders.
Stay updated on relevant billing regulations, coding guidelines, and payer requirements, ensuring compliance with all applicable standards.
Familiarity with clearinghouses and the billing functionality.
Assist with various data entry, administrative, and clerical tasks.