Reimbursement Specialist
About the role
The Home Infusion Biller is responsible for managing reimbursement activities related to home infusion services. This includes researching and resolving claim rejections and denials, documenting all account actions, and ensuring timely follow-up with Medicare, Medi-Cal, Managed Medi-Cal, and commercial payers (HMO and PPO).
Responsibilities
- Research and resolve claim rejections and denials
- Document all account actions
- Ensure timely follow-up with Medicare, Medi-Cal, Managed Medi-Cal, and commercial payers (HMO and PPO)
- May qualify for collection-based bonuses
Experience
- Minimum of 2 years of medical billing or collections experience in Home Infusion
- Experience with CPR+ (Mediware) and/or CareTend software is a plus
- Must have a solid understanding of medical terminology and insurance laws/guidelines
Skills
- Proficient in medical billing and CMS reimbursement guidelines
- In-depth knowledge of insurance verification and eligibility (Medicare Parts A-D, Medi-Cal, commercial plans)
- Familiarity with ICD-10, HCPCS, and NDC coding
- Experience with prior authorization submissions and appeals
- Competent in Microsoft Office (Word, Excel, Outlook) and EMR platforms
- Excellent analytical, time management, and organizational skills
- Strong math skills with the ability to calculate using whole numbers, fractions, and decimals
We are
Oso Home Care is a privately owned corporation founded in 1984. We are an equal opportunity employer.
Equal Opportunity Employer
Oso Home Care does not discriminate in employment with regard to race, color, religion, national origin, citizenship status, ancestry, age, sex, sexual orientation, marital status, physical or mental disability, military status, or any other characteristic protected by law.
Applicant and employee privacy policy
Applicant and employee privacy policy can be found at https://osohomecare.com.