Infusion Billing & Credentialing Specialist

Socket.dev; Irvine (CA); On-site; USD 60,000 - 90,000; Full time

Job summary

Socket.dev is seeking a Billing & Credentialing Specialist to manage the full revenue cycle for infusion services, including benefits investigation, claims submission, denials management, and AR follow-up. The role also handles provider credentialing with Medicare, Medi-Cal, and commercial payers, ensuring timely activation and HIPAA‑compliant processes to support patients and clinicians.

This position requires strong analytical skills, attention to detail, and effective communication with

Qualifications

• A minimum of 2 years of prior experience in a medical records department or like setting preferred.
• Prior experience with an Infusion clinic (preferred).
• Dealing with third party billers (preferred).

Responsibilities

• Verify medical benefits for infusion services and complete BI for deductibles and coverage limits.
• Process claims using CMS-1500 and UB-04 with correct infusion codes.
• Manage AR collections and follow-up on unpaid or underpaid claims.
• Handle denials, appeals, and reconsiderations with clinical documentation.
• Credentialing and enrollment for Medicare, Medi-Cal, and commercial plans.
• Coordinate with Prior Authorization team and ensure timely submissions.

Skills

Communication skills

Interpersonal skills

Analytical skills

Organizational skills

Tools

CMS-1500 forms

UB-04 forms

CAQH

NPPES

PECOS

Job description

Socket.dev is seeking a Billing & Credentialing Specialist to manage the full revenue cycle for infusion services, including benefits investigation, claims submission, denials management, and AR follow-up. The role also handles provider credentialing with Medicare, Medi-Cal, and commercial payers, ensuring timely activation and HIPAA‑compliant processes to support patients and clinicians.

This position requires strong analytical skills, attention to detail, and effective communication with