Reimbursement Manager (Billing)

Company: KabaFusion
Location: Cerritos
Posted on: May 7, 2022

Job 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 footprint. We opened our first pharmacy in 2010 in Southern California and now have 21 pharmacies and 24 nursing offices with a focus on IVIg, SCIg, acute infusion, and nutritional therapies.KabaFusion is a patient-focused national infusion therapy company providing Home Infusion Therapy Nursing Visits. KabaFusion continues to strive to set the standard of quality, compassionate nursing care to our patients and their families in the home setting. Our nurses are the very best experienced professionals in the field.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
• 3 Employee Assistance Programs (EAP)
• Emerging Leaders Training Program
• Perks--- includes discounts on travel, cell phone, clothing, and more---
• Employee Referral ProgramJOB SUMMARY:Reimbursement Manager oversees Reimbursement Department ensuring accurate claims submission and accurate payment of claims according to health plan guidelines.DUTIES & RESPONSIBILITIES:
  • Assures billing processes are compliant with payer requirement for Government, Commercial Health Plans and Medical Group payers.
  • Assures accurate billing of coding and units required by payer and therapy type.
  • Analyze and rectify claims issues with payers by timely follow u of claim status/payment.
  • Ensures accuracy and completeness of payer requirements prior to timely submission of claims to Health Plans, either electronic or hard copy.
  • Assures required authorizations and medical documentation forms are in correspondence with claim submission for quick turn-around time.
  • Reviews and assures claims are processed and paid in full according to contractual agreements.
  • Ensures revenue is booked according to appropriate contract allowable.
  • Communicates with branches and other departments to assure resolution of reimbursement issues.
  • Communicates and addresses reimbursement issues with management for resolution in a timely manner.
  • Must be able to prioritize, multi-task, meet goals and deadlines.
  • Protects patient health information by following regulations for HIPAA compliance.
  • Ensures daily productivity is met and monthly closing goals are met.PREFERRED EDUCATION & EXPERIENCE:
    • Bachelor's degree in business/ related field or education and experience to equal Bachelor's degree.
    • Candidate must be experienced with a minimum of 5 years (not including school or externship) 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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      PI175253225

Keywords: KabaFusion, Cerritos , Reimbursement Manager (Billing), Accounting, Auditing , Cerritos, California