Job Description

Job Title Medical Billing Manager

Salary 6,500,085,000 USD

Description

Come join an exciting and innovative company that puts the "care" back in healthcare!

WHY KABAFUSION?

KabaFusion is a home infusion company with a national network of pharmacist owned pharmacies with the ability to service 40+ states. While we are known for our expertise in IVIg and SCIg, we also provide acute infusion and nutritional therapies.

Where KabaFusion truly excels, is in its approach to patient care and positive clinical outcomes. With our dedicated and highly skilled clinical staff and in-house nursing with 24 hour on-call service; we are well equipped to care for our patients.

What we offer: * Competitive compensation

• Benefits start on your 1st day of employment
• 401K w/ 4% Match - no waiting or vesting period
• PTO / Floating Holidays / Paid Holidays
• Company Paid Life Insurance, STD, LTD
• 3 Employee Assistance Programs (EAP)
• Learning & Development Programs
• Perks... includes discounts on travel, cell phone, clothing, and more...
• Employee Referral Program

Experience what being a part of the KabaFusion family feels like!

JOB SUMMARY:

Medical Reimbursement Manager oversees Medical Reimbursement Department ensuring accurate claims submission and accurate payment of claims according to health plan guidelines.

DUTIES & RESPONSIBILITIES: * Assures billing processes are compliant with payer requirement for Government, Commercial Health Plans and Medical Group payers.

• Assures accurate billing of coding and units required by payer and therapy type.
• Analyze and rectify claims issues with payers by timely follow u of claim status/payment.
• Ensures accuracy and completeness of payer requirements prior to timely submission of claims to Health Plans, either electronic or hard copy.
• Assures required authorizations and medical documentation forms are in correspondence with claim submission for quick turn-around time.
• Reviews and assures claims are processed and paid in full according to contractual agreements.
• Ensures revenue is booked according to appropriate contract allowable.
• Communicates with branches and other departments to assure resolution of reimbursement issues.
• Communicates and addresses reimbursement issues with management for resolution in a timely manner.
• Must be able to prioritize, multi-task, meet goals and deadlines.
• Protects patient health information by following regulations for HIPAA compliance.
• Ensures daily productivity is met and monthly closing goals are met.

PREFERRED EDUCATION & EXPERIENCE: * Bachelor's degree in business/ related field or education and experience to equal Bachelor's degree.

• Candidate must be experienced with a minimum of 5 years (not including school or externship) in Home Infusion.
• Knowledge and understanding of HCPC and CPT codes
• Strong understanding of insurance terms, medical terminology, pricing methodologies for commercial and government billing requirements.

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