Revenue Cycle Management Specialist - Billing

Priority Dispatch Corp.; Oklahoma City (OK); On-site; USD 42,000 - 54,000; Full time

Job summary

Priority Dispatch Corp. is seeking a billing professional to accurately submit third-party insurance claims and resolve payer issues. You will verify documentation, Code accuracy, and follow up on rejected claims while communicating with patients about billing matters.

The role requires attention to detail, HIPAA compliance, and familiarity with Medicare, Medicaid, and commercial payers. The ideal candidate has 1–3 years of Home Infusion or Specialty Pharmacy billing experience, plus proficiency

Qualifications

• Read and interpret medical records for billing purposes.
• Possess strong math skills and numeric accuracy.
• Compute unit conversions for drugs and CPT/HCPCS usage.
• Demonstrate attention to detail and effective communication.
• Understand HIPAA regulations and patient confidentiality.
• Self-directed with minimal supervision.
• Proficient in Excel, Outlook, and office applications.
• Familiarity with pharmacy management systems CPR+, WellSky, CareTend.
• Knowledge of billing requirements for Medicare, Medicaid, and commercial payers.

Responsibilities

• Accurately prepare and submit claims for payment from third-party payers in a timely manner.
• Verify documentation aligns with prepared claims and verify billed codes and amounts.
• Follow up on submitted claims and resolve rejections and adjustments.
• Prepare and submit patient statements and respond to billing inquiries.
• Maintain up-to-date records and support inter-department collaboration.
• Assist process improvement initiatives within the billing department.
• Ensure compliance with laws and accreditation standards; participate in audits.

Skills

Medical billing comprehension

Mathematical proficiency

Drug unit conversions

Attention to detail

HIPAA compliance

Self-directed work style

MS Excel

Outlook proficiency

Pharmacy management systems

Payer billing knowledge

Education

High school diploma or GED

Tools

CPR+

WellSky

CareTend

Job description

Job Duties:Accurately prepare and submit claims for payment from all third-party payers in a timely manner.Verify documentation of supplied products align with prepared claim.Verify accuracy of billed codes and accuracy of billed and expected amounts.Support the resolution of billing issues such as claim resubmissions to all payers, changes in coverage, and claims adjustments.Follow up on submitted claims and resolve rejected claims, including claim corrections, update payer ID, update patient insurance record, etc.Prepare and submit patient statements.Communicate as needed with patients about billing issues, including the results of applications for financial hardship assistance and other responses to customer inquiries about billing.Support accurate and comprehensive record-keeping to ensure up-to-date information is maintained and effectively shared across departments.Assist in the implementation of processes to measure, assess, and improve the performance of the billing department activities of the company.Ensure ongoing compliance with all laws and regulations; ensure that the department meets or exceeds accreditation standards; and implement \"best practices\" in all departmental activities.Participate in surveys conducted by authorized inspection agencies.Participate in the company's Performance Improvement program as requested by the Performance Improvement Coordinator.Participate in company committees when requested.Participate in in-service education programs provided by the company.Pursue continuing education programs appropriate to job responsibilities.Perform other duties as assigned by supervisor.Complete all mandatory and regulatory training programs.Report any misconduct, suspicious or unethical activities to the Compliance Officer.Complies with accepted professional standards and practice.Job Skill Requirements:Ability to read and interpret medical records for billing purposes.Competent in mathematic equations.Ability to compute unit conversions for drugs.Understanding of CPT, HCPCS, and ICD-10 codesHas excellent attention to detail and communication skills.Understanding of HIPAA compliance.Self-directed, has the ability to work with little supervision.Proficiency in Excel, Outlook, and all other office applications.Familiarity with pharmacy management systems (CPR+, Wellsky, and CareTend, etc.)Familiar with billing requirements for various payers (Medicare, Medicaid, Commercial, etc.)Knowledge and experience submitting pharmacy and medical claims electronically or on paper.Educational Requirements:High school diploma or GEDExperience:One to three years of experience in Home Infusion or Specialty Pharmacy billing.