The Billing Specialist is responsible for managing insurance and self-pay billing, including the submission of electronic and paper claims. They must also monitor billing requirements, resolve claim rejections, and coordinate with the pharmacy team to ensure timely revenue processing.
Develop and manage strategic relationships with IPAs, medical groups, and hospitals to expand market access and drive referral growth for specialty pharmacy and infusion services. Collaborate with internal teams to implement provider agreements and monitor market trends to optimize growth strategies.
The specialist processes new referrals by verifying patient insurance eligibility, calculating out-of-pocket costs, and coordinating benefits. They are also responsible for the submission and follow-up of payer authorization requests and preparing start-of-care paperwork.
Responsible for processing new referrals by verifying patient insurance eligibility and calculating estimated out-of-pocket costs. Manages the preparation, submission, and follow-up of payer authorization requests and clinical documentation.
