Description

JOB TITLE: Infusion Billing Specialist II

EMPLOYER: Twelfth One, LLC dba Aspen Infusion 

DEPARTMENT: Billing 

REPORTS TO: Reimbursement Manager 

PAY RANGE: $24 - $26 per hour based on experience

SUMMARY: The Infusion Billing Specialist is responsible for the accuracy and timeliness of the company’s billing functions and efficient processing, including interactions with the Reimbursement Team while maintaining accurate records. 

DUTIES AND RESPONSIBILITIES:

• Ensure daily accomplishments work towards company goals for cash collections and Accounts Receivable over 90 days, Ready to Bill under 14 days, weekly and month-end close processes, and other departmental goals as outlined. 
• Understand and adhere to state and federal regulations and company policies regarding compliance, integrity, patient privacy, and ethical billing practices. 
• Manage the Ready to Bill queue daily; perform Quality Assurance to ensure accurate and timely creation of new claims and generic invoices; ensure submitted claims meet payer guidelines. 
• Work "resolved" unbilled tickets within 24 hours to "ready" or next status for resolution. 
• Conduct billing utilizing the most efficient resources to secure timely payment of open claims or invoices, giving priority to electronic solutions. 
• Review delivery tickets for accuracy and complete claims per payer-specific guidelines. 
• Submit secondary billing in a timely manner with appropriate supporting documentation per payer-specific guidelines to ensure expected revenue is allowed. 
• Research websites of assigned payers to bill for payer updates and share updates accordingly. 
• Work within specified deadlines and stressful situations. 
• Work overtime when necessary to meet department goals and objectives. 
• Stay up to date on industry standards set by the Centers for Medicare & Medicaid (CMS), and commercial insurance plans by attending seminars, conferences, and other programming related to claims and billing. 
• Performs other tasks or special projects as assigned by management. 

SUPERVISORY RESPONSIBILITIES:

• This job has no supervisory responsibilities.

Requirements

QUALIFICATIONS:

• High school diploma or general education degree (GED); some college a plus. 
• A minimum of 3 to 5 years of experience in medical billing with a working knowledge of managed care, commercial insurance, Medicare and Medicaid reimbursement; home infusion experience is a plus 
• Medical and Billing Coding Certificate required 
• Working knowledge of automated billing systems, experience with CareTend preferred 
• Working knowledge and application of metric measurements, basic accounting practices, ICD-10, CPT, and HCPCS coding 
• Ability to independently obtain and interpret information 
• Strong verbal and written communication skills 
• Ability to prioritize, problem-solve, and multitask is required. 
• Knowledge of CMS regulations and requirements regarding billing and coding. 
• Experience working with all payers – commercial, government, Medicare, and Medicaid. 
• Must be able to work in a fast-paced environment 

COMPETENCIES:

• Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethics; Upholds organizational values. 
• Attendance/Punctuality - Is consistently at work and on time; Ensures work responsibilities are covered when absent; Arrives at meetings and appointments on time. 
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments. 
• Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality. 
• Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed. 
• Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information. 
• Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings. 

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

• Continually required to stand, walk, sit, talk, and hear. 
• Continually required to utilize hand and finger dexterity 
• While performing the duties of this job, the noise level in the work environment is usually moderate
• The employee must occasionally lift and/or move up to 30 pounds 
• Specific vision abilities required by this job include: Close vision; Depth perception and the ability to adjust focus

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The above is intended to describe the general content of and requirements for the performance of this job.? It is not to be construed as an exhaustive statement of duties, responsibilities, or physical requirements.? Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.