Billing Specialist
RemoteUnited States
Job Summary
Review patient accounts, verify documentation and authorizations, and prepare professional, facility, infusion, and pharmacy claims for submission within payer deadlines. Monitor claim transmission reports, resolve rejections by correcting edits and resubmitting within turnaround times, and coordinate with pharmacy teams regarding prescription and reimbursement requirements. Validate HCPCS, CPT, and ICD-10 codes for infusion therapies, home infusion services, and specialty pharmacy claims to ensure compliance with payer guidelines and contractual obligations. Collaborate with intake, prior authorization, and accounts receivable teams to prevent billing delays and maintain revenue integrity across assigned clients.
Required Qualifications
- High School Diploma or GED
- High school diploma or GED
Desired Qualifications
- Minimum 1 years of healthcare billing experience
- Experience in infusion services, specialty pharmacy, physician billing, hospital outpatient billing, or home infusion
- Experience with Medicare, Medicaid, and commercial insurance billing
- Experience with infusion-specific reimbursement methodologies
- Strong understanding of medical billing and reimbursement processes
- Knowledge of HCPCS, J-Codes, CPT, ICD-10, modifiers, and payer billing requirements
- Understanding of infusion drug reimbursement and administration billing
- Familiarity with specialty pharmacy billing and adjudication processes
- Knowledge of claim submission, claim edits, and rejection management
- Strong attention to detail and accuracy
- Excellent organizational and time management skills
- Proficiency with EMR, practice management, and billing software systems
- Intermediate Microsoft Excel skills
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.