Medical Biller - Specialty Pharmacy 24-00955 - Alura Workforce Solutions

Job Title:
Home Infusion Biller (IVIG and TPN Billing Specialist)

Job Summary:
We are seeking a skilled and experienced Home Infusion Biller with expertise in IVIG (Intravenous Immunoglobulin) and TPN (Total Parenteral Nutrition) billing. The ideal candidate will have a strong background in medical billing and coding for home infusion services, with a focus on handling complex claims for high-cost specialty therapies. This role involves collaborating with healthcare providers, insurance companies, and patients to ensure timely and accurate reimbursement for services rendered.

Key Responsibilities:

• Billing and Coding:
  • Accurately process claims for IVIG, TPN, and other home infusion services in compliance with payer guidelines.
  • Apply appropriate medical billing codes (CPT, ICD-10, and HCPCS) for infusion therapies and associated supplies.
• Claims Management:
  • Submit claims electronically or via paper to insurance carriers, including private insurers, Medicare, and Medicaid.
  • Monitor and follow up on unpaid or denied claims, resolving discrepancies to ensure payment.
• Authorization and Verification:
  • Obtain and verify pre-authorizations for IVIG, TPN, and other high-cost therapies prior to service delivery.
  • Review insurance coverage and eligibility, ensuring compliance with payer requirements.
• Revenue Cycle Management:
  • Track accounts receivable and manage reimbursement processes to ensure accurate payments.
  • Investigate and resolve billing issues or discrepancies to maximize revenue collection.
• Compliance:
  • Stay updated on billing regulations and payer-specific requirements for home infusion services.
  • Ensure all claims and documentation meet compliance standards, including HIPAA.
• Patient Interaction:
  • Communicate with patients regarding billing inquiries, payment plans, and insurance benefits.

Qualifications:

• Education:
  • High school diploma or equivalent required; associate degree or certification in medical billing and coding preferred.
• Experience:
  • Minimum of 2-3 years of experience in home infusion billing
  • Proficiency in IVIG and TPN billing is mandatory.
  • Familiarity with home infusion software systems (e.g., CPR+, Brightree, or CareTend) is a plus.
• Skills:
  • Strong knowledge of payer guidelines for infusion therapies.
  • Excellent analytical, organizational, and communication skills.
  • Proficiency in medical terminology and coding systems (CPT, ICD-10, HCPCS).
  • Ability to work independently and handle multiple tasks in a fast-paced environment.

Preferred Qualifications:

• Certification in medical billing and coding (e.g., CPC, CCA, or CCS).
• Experience working in a specialty pharmacy or infusion therapy billing environment.

Benefits:

• Competitive salary and benefits package.
• Opportunities for professional growth and continuing education.
• A supportive work environment with a focus on patient-centered care.

INDH