Infusion and Specialty Drug Revenue Cycle Specialist

Location

Texas

Posted

96 days ago

Salary

0

Seniority

Mid Level

High School2 yrs expEnglish

Job Description

Infusion and Specialty Drug Revenue Cycle Specialist

House + Home Loans

• Submit accurate claims for infusion therapies, injectable medications, and physician-administered drugs to insurance payers • Track claims to ensure timely processing and reimbursement • Identify and address claim rejections and denials promptly • Reconcile payments and outstanding balances for infusion and injectable drug claims • Maintain detailed records of payer communications and payment status • Confirm insurance eligibility and coverage for infusion therapies and physician-administered drugs • Collaborate with pharmacy and clinical teams to obtain prior authorizations when required • Ensure claims comply with payer policies, coding standards, and regulations • Maintain organized and accurate documentation for audit purposes • Identify opportunities to optimize the infusion and medical benefit drug billing process

Job Requirements

  • High School Diploma or equivalent (higher degree accepted)
  • 2 years of experience in infusion billing, buy-and-bill processes, specialty pharmacy billing, or medical benefit drug reimbursement
  • Experience in oncology, rheumatology, or infusion center settings is highly desirable
  • 1 year Familiarity with specialty pharmacy operations is a plus
  • Advanced knowledge of medical terminology, ICD 10, CPT, HCPCS coding and HIPAA requirements
  • Ability to communicate effectively, both orally and in writing
  • Demonstrated proficiency in the use of computer and commonly used software, including electronic medical records (EMR)
  • Extensive knowledge and experience with commercial, government and state billing and reimbursement procedures
  • Proficiency in insurance verification, prior authorization, and AR follow-up
  • Attention to detail, organizational skills, customer service orientation, and analytical thinking

Benefits

  • Health insurance
  • Flexible work arrangements
  • Professional development opportunities

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