RCM Billing Specialist (Part Time)

InfuSystem is a growing healthcare service provider, specializing in infusion pumps and related products and services for patients in hospitals, clinics, ambulatory surgery centers, and other major service centers. We provide direct payer rentals, pump and consumable sales, and biomedical services and repair, serving all 50 states and Canada. Headquartered in Rochester Hills, Michigan, we have Centers of Excellence in Kansas, California, Massachusetts, Texas and Ontario, Canada.

As a leader in our field, our mission is to provide quality infusion services to patients and medical practices, including a 24‐hour clinical support hotline. Our team effort provides product management and clinical support to enhance the lives of our patients and the communities we serve. Service is always our highest priority; keeping the patients’ health & safety at the center of everything we do.

SUMMARY:

The Revenue Cycle Billing Specialist is responsible for the management of activities relative to third party payer billing. This includes, benefit verification, obtaining authorizations and timely and accurate filing of claim submission. Ensuring that all claims billed are following all federal and state requirements and meeting the requirements of payers. This position should have billing work experience in DME and other healthcare related services.

IN THIS ROLE, THE IDEAL CANDIDATE WILL:

• Have capability to interpret payer explanation of benefits (EOBs) to ensure proper reimbursement of claims and report any problems, issues, or payer trends to management
• Work with payers and/or payer web portals to determine reasons for front end denials and correct and resubmit claims for reimbursement in a timely manner
• Conduct insurance reverification as needed through various tools and initiate billings to a new payer or reprocess the claim accordingly or bill patient
• Process third party payer correspondence, refunds, and adjustments timely
• Remain up to date on payer informational notices and changes
• Share information and ideas for process improvements with team
• Respond to all patient inquiries timely
• Comply with all work instructions, policies and behavioral expectations

QUALITY AND QUANTITY OF WORK

Team members will be responsible for hitting regular productivity targets with a high level of quality. Quality audits will be performed on a regular basis and feedback and education will be provided to the team member to help support growth and development.

SUPERVISORY RESPONSIBILITIES:

This position has no supervisory responsibilities

THE IDEAL CANDIDATE WILL HAVE THE FOLLOWING QUALIFICATIONS:

• Associate Degree or equivalent preferred; minimum two years related experience; or equivalent combination of education and experience
• Preferred experience related to Negative Pressure Wound Therapy
• Organizational skills
• Good troubleshooting skills
• Strong attention to detail
• Proficient with Word, Excel, Outlook
• Operate Express/HDMS/WayStar proficiently
• Understanding of insurance guidelines including Medicare, Medicaid, Workers Compensation and all Commercial managed-care plans
• Ability to handle inquiries and respond via telephone or in writing
• Ability to explain and resolve collections related questions/issues to patients, sales representatives and facilities
• Proper use of ICD-10, CPT and HCPCS codes
• Ability to independently meet tight deadlines in a project-based atmosphere

PERSONAL AND PROFESSIONAL ATTRIBUTES:

The ideal candidate must be a rigorous analytical thinker and problem solver with the following professional attributes:

• Strong work ethic
• Sound judgment
• Proven written and verbal communication skills
• Natural curiosity to pursue issues and increase expertise
• Pursue and design innovative analytical performance metrics
• The courage to promote and defend ideas and analyses
• Passionate about InfuSystem and serving customers and patients
• Strives to make an impact on improving our business processes and results
• Exemplary honesty and integrity
• Ability to collaborate effectively and work selflessly as part of a team

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Originally posted on Himalayas