Infusion Claims & Reimbursement Specialist

Prochant; United States, Northern America, Americas; Sur place; USD 42 000 - 60 000; Plein temps

Avantages offerts par ce poste

Health Insurance

Dental Insurance

Vision Insurance

Short Term Disability

Long Term Disability

Life Insurance

401K with company match

Pre-Paid Legal

Résumé du poste

Prochant is seeking an Infusion Reimbursement Specialist to manage timely and accurate processing of infusion and DME claims in the U.S. healthcare billing environment.

You will verify benefits, handle prior authorizations, and ensure clean claim submission in compliance with CMS and payer guidelines. Ideal candidates have a high school diploma or GED, 2+ years in infusion/DME billing, and experience with Bright Tree, CPR+, CareTend, or WeInfuse.

Qualifications

• High school diploma or GED.
• Deep knowledge and experience billing and collecting major medical claims for home infusion, ambulatory infusion, and/or specialty pharmacy.
• 2+ years directly related Infusion and DME experience preferred.
• Experience using Bright Tree, CPR+, CareTend, or WeInfuse software.
• General knowledge of HCPCS, NDC, CPT, and ICD-10 coding.
• Ability to demonstrate a clear understanding of CMS 1500 and 837 claim formatting and billing process.

Responsabilités

• Ensures receipt and validity of all documents needed to prepare and submit billing and claims accurately.
• Understand benefits verification, prior authorization, date spans, and HCPC unit calculations.
• Timely and accurate insurance claim submission to government, non-government, and third-party payors.
• Research claim denials and resolve associated AR in a timely manner.
• Conduct frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers.
• Provide, submit, and coordinate all necessary documentation to be in compliance with payor requirements and collaborate with internal/external teams.

Connaissances

Infusion billing

DME claims

Payer communication

CMS 1500/837

Coding knowledge

Formation

High school diploma or GED

Outils

Bright Tree

CareTend

CPR+

WeInfuse

Description du poste

Prochant is seeking an Infusion Reimbursement Specialist to manage timely and accurate processing of infusion and DME claims in the U.S. healthcare billing environment.

You will verify benefits, handle prior authorizations, and ensure clean claim submission in compliance with CMS and payer guidelines. Ideal candidates have a high school diploma or GED, 2+ years in infusion/DME billing, and experience with Bright Tree, CPR+, CareTend, or WeInfuse.