Soleo Health is seeking a Billing Specialist to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care! 2 years of home infusion billing experience is required
Home infusion billing experience required.
- Competitive Wages
- 401(k) with a Match
- Referral Bonus
- Paid Time Off
- Great Company Culture
- Annual Merit Based Increases
- No Weekends or Holidays
- Paid Parental Leave Options
- Affordable Medical, Dental, and Vision Insurance Plans
- Company Paid Disability and Basic Life Insurance
- HSA and FSA (including dependent care) Options
- Education Assistance Program
The Position:
The Billing Specialist will primarily be responsible for insurance and self-pay billing, excluding Medicare. This role is also responsible for submitting electronic and paper claims. Follows up with clearing house vendors on accepted and working rejections.
Responsibilities include:
- Preparation of accurate medical claims based on contracted agreements for services to various payers (e.g. Commercial Payers, Government Payers, Employer/ Institutional Payers).
- Reviewing and identifying claims pricing discrepancies based on updates/changes to fee schedules.
- Creates and submits secondary electronic pharmacy and medical claims in a timely manner.
- Billing of manufacturer copays, which includes entering the necessary information into portal or billing via paper at time of initial billing.
- Monitors billing requirements pursuant to contracts with third party payers or government programs.
- Answer insurance/billing questions from branch staff and help educate.
- Review information from electronic medical records in patient account (IE: auth, benefit verification, orders, accounts receivable, etc.) to ensure preparation and submission of clean claims.
- Perform routine revenue review of claims billed within the current month.
- Answering incoming calls and triage if necessary.
- Create claim batches and process them via electronic submission.
- Manually process any claims that are not eligible for electronic billing. Identify any claims that need attention, make corrections, and resubmit.
- Ensure coding to the highest level of specificity and for maximum reimbursement by third party payers.
- Daily review and follow up of unbilled delivery tickets in billing review and ready to bill queues.
- Accurately notate patient accounts to reflect all actions made including marginal, split claim notes, missing COGS, etc.
- Coordinates with the pharmacy team daily to ensure any PBM issues are addressed and resolved, accepted into revenue and billed timely
- Effectively utilize time and resources to meet performance goals.
- Provides exceptional Customer service to internal and external customers.
- Ensures compliance with federal, state, and local governments, third party contracts, and company policies.
- Clearly communicate any billing related issues to all appropriate parties including: Intake, collections, RBL, and manager.
- Monitoring the unbilled-pending invoices queues and communicate to the branch on missing or needed documents or information.
- Maintain current knowledge of departmental and organizational policies.
Schedule:
- Monday - Friday, 8:30am - 5pm
