Overview
We are seeking a dedicated and detail-oriented Revenue Cycle Specialist specializing in Insurance Follow-Up and Infusion Billing. The ideal candidate will possess a comprehensive understanding of medical billing processes, insurance claim management, and infusion therapy reimbursement procedures. In this role, you will be responsible for optimizing revenue flow by ensuring accurate and timely follow-up on insurance claims, managing complex billing workflows, and maintaining compliance with healthcare regulations. Your expertise will contribute significantly to the financial health of our organization while supporting seamless patient care delivery.
Responsibilities
- Conduct thorough follow-up on unpaid or denied insurance claims related to infusion services, ensuring prompt resolution.
- Review and analyze medical records, billing documentation, and coding information to identify discrepancies or issues affecting reimbursement.
- Utilize Electronic Medical Record (EMR) and Electronic Health Record (EHR) systems to track claim status and update patient billing records accurately.
- Apply knowledge of DRG (Diagnosis-Related Group), CPT (Current Procedural Terminology) coding, ICD-9, and ICD-10 coding standards to ensure precise claim submission.
- Collaborate with insurance companies to appeal denied claims and negotiate payment resolutions effectively.
- Maintain detailed documentation of all follow-up activities, communications, and adjustments for audit purposes.
- Stay current with evolving medical billing regulations, ICD coding updates, and healthcare policies to ensure compliance.
Requirements
- Proven experience in medical billing, medical coding, or revenue cycle management within a healthcare setting.
- Strong understanding of DRG, CPT coding, ICD-9, ICD-10, and medical terminology relevant to infusion therapy billing.
- Proficiency in Epic or similar billing systems required
- Knowledge of clearinghouse workflows
- Demonstrated ability in medical collections and resolving insurance claim issues efficiently.
- Excellent organizational skills with attention to detail in managing multiple claims simultaneously.
- Effective communication skills for liaising with insurance providers, patients, and internal teams.
- Prior experience in a medical office environment or healthcare revenue cycle department is preferred.
Join our team as a Revenue Cycle Specialist to play a vital role in maximizing reimbursement processes while supporting exceptional patient care through meticulous billing practices!
Pay: $22.00 - $32.00 per hour
Work Location: In person
