Billing Specialist

Summary

Vital Care Infusion Services is a pharmacy franchise business serving patients with chronic and acute conditions through infusion pharmacies and clinics. The Billing Specialist processes home infusion medical claims accurately and promptly, resolves rejected claims, maintains billing records, documents account activity, and supports revenue cycle training and procedures in a fully remote role.

Responsibilities

• Create and submit medical, pharmacy and third-party vendor claims timely and accurately. Ensure all revenue opportunities are included, and complete and submit billing to primary and secondary payers
• Resolve rejected electronic claims so that current submission is successful and future submissions are not rejected
• Maintain ready-to-bill delivery tickets and indicate tickets that cannot be billed with appropriate status for communication purposes within RCM and Franchises
• Document case activity, communications, and correspondence in CareTend to ensure completeness and accuracy of account activity
• Contribute medical billing expertise to the design of training and knowledge transfer programs, materials, policies, and procedures to improve the efficiency and effectiveness of the RCM team
• Perform other related duties as assigned

Skills

• * Excellent communications skills; listening, speaking, understanding, and writing English while influencing patients, caregivers, payer representatives, and others, answering questions, and advancing reimbursement and collection efforts
• * Proven understanding of processes, systems, and techniques to ensure successful billing and collection working with all payer types
• * Proven ability to identify gaps and problems from a review of documentation, determine lasting solutions, make effective decisions, and take necessary corrective action
• * Strong organization skills with the ability to track and maintain clear, complete records of activities, cases, and related documentation
• * Proven knowledge and skill in the utilization of MS Office suite of software and pharmacy applications
• * Ability to complete job duties in a designated workspace outside the dedicated RCM location
• * Disciplined work ethic with ability to work remotely with little direct supervision and meet production and collection targets
• * 2-5 years home infusion billing and/or collections experience required
• * High School Diploma and additional specialized training in intake, pharmacy/medical billing, and/or collections
• * Detailed oriented with post-billing and post-payment investigative experience preferred
• * Sitting: Prolonged periods of sitting are typical, often for the majority of the workday
• * Keyboarding: Frequent use of a keyboard for typing and data entry
• * Reaching: Occasionally reaching for items such as files, documents, or office supplies
• * Fine Motor Skills: Precise movements of the fingers and hands for tasks like typing, using a mouse, and handling paperwork
• * Visual Acuity: Good vision for reading documents, computer screens, and other detailed work
• Vital Care is a U.S.-based employer and hires only individuals who are authorized to work in the United States and who perform their work from within the United States
• Applicants and employees must accurately disclose their current work location and work authorization status during the application and hiring process
• * Previous remote work environment is a plus but not required
• * Experience in an infusion suite setting is a plus

Qualifications

Must Haves

• * Excellent communications skills; listening, speaking, understanding, and writing English while influencing patients, caregivers, payer representatives, and others, answering questions, and advancing reimbursement and collection efforts
• * Proven understanding of processes, systems, and techniques to ensure successful billing and collection working with all payer types
• * Proven ability to identify gaps and problems from a review of documentation, determine lasting solutions, make effective decisions, and take necessary corrective action
• * Strong organization skills with the ability to track and maintain clear, complete records of activities, cases, and related documentation
• * Proven knowledge and skill in the utilization of MS Office suite of software and pharmacy applications
• * Ability to complete job duties in a designated workspace outside the dedicated RCM location
• * Disciplined work ethic with ability to work remotely with little direct supervision and meet production and collection targets
• * 2-5 years home infusion billing and/or collections experience required
• * High School Diploma and additional specialized training in intake, pharmacy/medical billing, and/or collections
• * Detailed oriented with post-billing and post-payment investigative experience preferred
• * Sitting: Prolonged periods of sitting are typical, often for the majority of the workday
• * Keyboarding: Frequent use of a keyboard for typing and data entry
• * Reaching: Occasionally reaching for items such as files, documents, or office supplies
• * Fine Motor Skills: Precise movements of the fingers and hands for tasks like typing, using a mouse, and handling paperwork
• * Visual Acuity: Good vision for reading documents, computer screens, and other detailed work
• Vital Care is a U.S.-based employer and hires only individuals who are authorized to work in the United States and who perform their work from within the United States
• Applicants and employees must accurately disclose their current work location and work authorization status during the application and hiring process

Nice to Haves

• * Previous remote work environment is a plus but not required
• * Experience in an infusion suite setting is a plus

Benefits

• Comprehensive medical, dental, and vision plans, plus flexible spending and health savings accounts.
• Paid time off, personal days, and company-paid holidays.
• Paid Paternal Leave.
• Volunteerism Days off.
• Company-sponsored basic life insurance and long-term disability insurance.
• Employee-paid voluntary life, accident, critical illness, and short-term disability insurance.
• 401(k) matching and tuition reimbursement.
• Employee assistance programs including mental health, financial, and legal support.
• Rewards programs offered by our medical carrier.
• Professional development and growth opportunities.
• Employee Referral Program.
• 100% remote position.