Reimbursement Specialist
About The Position
The Home Infusion Biller is responsible for managing reimbursement activities related to home infusion service s. This includes researching and resolving claim rejections and denials, documenting all account actions, and ensuring timely follow-up with Medicare, Medi-Cal, Managed Medi-Cal, and commercial payers (HMO and PPO). The position may qualify for collection-based bonuses. Monday to Friday 8 am - 4:30 pm. Oso Home Care is an equal opportunity employer. Oso Home Care does not discriminate in employment with regard to race, color, religion, national origin, citizenship status, ancestry, age, sex, sexual orientation, marital status, physical or mental disability, military status, or any other characteristic protected by law. Applicant and employee privacy policy can be found at https://osohomecare.com
Requirements
- Minimum of 2 years of medical billing or collections experience in Home Infusion
- Must have a solid understanding of medical terminology and insurance laws/guidelines
- Proficient in medical billing and CMS reimbursement guidelines
- In-depth knowledge of insurance verification and eligibility (Medicare Parts A-D, Medi-Cal, commercial plans)
- Familiarity with ICD-10, HCPCS, and NDC coding
- Experience with prior authorization submissions and appeals
- Competent in Microsoft Office (Word, Excel, Outlook) and EMR platforms
- Excellent analytical, time management, and organizational skills
- Strong math skills with the ability to calculate using whole numbers, fractions, and decimals
Nice To Haves
- Experience with CPR+ (Mediware) and/or CareTend software is a plus
Responsibilities
- managing reimbursement activities related to home infusion service s
- researching and resolving claim rejections and denials
- documenting all account actions
- ensuring timely follow-up with Medicare, Medi-Cal, Managed Medi-Cal, and commercial payers (HMO and PPO)
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
Number of Employees
101-250 employees
