Infusion Reimbursement Specialist

The Infusion Reimbursement Specialist is responsible for multiple areas that are key to success for Prochant, a billing service and process outsourcing company in the U.S. healthcare industry. The Infusion Reimbursement Specialist is responsible for the timely and accurate processing of claims. Following guidelines established by company policies, state or federal imposed billing requirements or insurance guidelines for best billing practices, the biller ensures clean claim submission to health plans Reimbursement Specialist responsibilities include:

• Ensures receipt and validity of all documents needed in order to prepare and submit all billing and claims accurately.
• Responsible to understand benefits verification and prior authorization numbers, date spans, and HCPC unit calculations.
• Completes and submits all necessary insurance forms and electronic claims to process them in accordance to the timely filing requirements set by all third-party payors.
• Provides all necessary documentation required to expedite payments. This includes, but not limited to, demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians
• Coordinates with inter-departmental associates to obtain appropriate documentation as needed for billing.
• Communicates with supervisor on a daily and/or weekly basis regarding any outstanding claims issues related to system, authorizations, wrong pay plans, nursing notes.
• Conducts frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers as needed.

• High school diploma or GED
• Deep knowledge and experience billing and collecting major medical claims for home infusion, ambulatory infusion, and/or specialty pharmacy.
• Two (2)+ years directly related Infusion and DME experience preferred.
• Experience using Bright Tree, CPR+, CareTend, or WeInfuse software.
• General knowledge of HCPCS, NDC, CPT, and ICD-10 coding.
• Ability to demonstrate a clear understanding of CMS 1500 and 837 claim formatting and billing process.

Prochant offers some of the best benefits in the industry! We take great care of our employees. Prochant’s Fortune 500 level benefits package includes:

• Health Insurance
• Gap Insurance
• Dental Insurance
• Vision Insurance
• Short Term / Long Term Disability (company paid)
• Term Life Insurance (company paid, employee can elect additional)
• Full suite of CHUBB supplemental insurance plans, including: Disability Income, Level Term Life, Accident Insurance, & Critical Illness Insurance

• Floating holidays and paid time off
• Pre-Paid Legal
• 401K with company match