Job Description

Job Title Medical Billing Specialist

Salary 2,227 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:

The Medical Billing Specialist is responsible for accurate claims submission and accurate payment of claims according to payor guidelines.

DUTIES & RESPONSIBILITIES: * Exhibits the ability to prioritize, multi-task and meet daily productivity and month-end closing deadlines.

• Understands eligibility, benefits, authorization verification for treatments, complex payer contract terms, fee schedule for all payers.
• Verifies that the services and products are correctly authorized.
• Ensures accuracy and appropriateness of claim type, diagnosis codes, place of service, procedure codes, HCPC or NDC units for drugs, per diem, proper use of modifiers, and dates of service as defined by government payers and contracted plans.
• Certifies the accuracy and completeness of payer requirements prior to timely submission of clean claims to various insurance companies, either through an electronic or hard copy.
• Manages Billing Que status code to track unbilled delivery ticket(s) and maintains Reimbursement Pending Item Report, facilitates resolution, and ensures timeliness of claims submission.
• Actively communicates status of assigned work, escalated billing concerns and challenges that could affect claims submission and processing with the Supervisor/Manager.
• Collaborates with pharmacy to ensure rejected claim correction is resolved timely and has payable status in Claims to Adjudicate queue
• Manage Billing Que to create and process claims in accordance with departmental expectations.
• All efforts to obtain the Billing Requests, documents from the other respective departments will be recorded in the billing note.
• Protects patient health information by following regulations for HIPAA compliance.

PREFERRED SKILLS & EXPERIENCE: * High School Diploma or equivalent education.

• Candidate must be experienced with a minimum of 1-2 years 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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