The Billing Specialist is responsible for accurately creating and submitting medical and pharmacy claims to ensure timely reimbursement and reduced denial rates. They also document case activity in CareTend and contribute to the development of training materials to improve RCM team efficiency.
Process home infusion medical claims accurately and timely to reduce denial rates and bad debt. Maintain case documentation and resolve rejected claims while ensuring compliance with standard billing practices.
Manage multiple teams responsible for patient referrals, insurance authorizations, billing, and collections within infusion pharmacy business units. Cultivate a high-performing team environment while ensuring regulatory compliance and meeting financial performance metrics.
The specialist is responsible for collecting outstanding patient accounts receivable and managing payment arrangements for franchise partners. They must maintain clear financial communication with patients and caregivers while ensuring accurate documentation and adherence to HIPAA compliance.
Collect outstanding home infusion claims by reviewing account balances, following up with insurers and patients, investigating denials, and submitting appeals. Document collection activity, communicate with franchise partners and internal teams, identify billing issues and revenue opportunities, and recommend process improvements to reduce denials, days sales outstanding, and bad debt.
The Collections Specialist is responsible for managing the revenue cycle by collecting on home infusion claims, analyzing denials, and submitting appeals to ensure timely payment. They also communicate financial obligations to patients and maintain accurate documentation of all collection activities.
The Collections Associate manages accounts receivable by following up on outstanding insurance balances and resolving claim denials or underpayments. They collaborate with internal teams to ensure accurate documentation and meet organizational revenue cycle goals.
Process patient referrals by verifying benefits, obtaining prior authorizations, and ensuring accurate billing to reduce denial rates. Maintain detailed documentation of case activity and communicate effectively with franchise partners and payers to resolve outstanding claims.
Process medical claims for home infusion services while ensuring accuracy and timeliness to reduce denial rates. Maintain detailed documentation of case activity and communications within the CareTend system.
