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Reimbursement Audit Representative

Company: KabaFusion
Location: Cerritos
Posted on: June 18, 2022

Job Description:

KabaFusion is a home infusion company with exceptional employees!
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 in 15 states with a focus on IVIg, SCIg, acute infusion, and nutritional therapies.
Our success is the result of teamwork from our dedicated staff who truly believe in putting the "care" back in healthcare. A career at KabaFusion means joining a team that lives by its values and empowers team members to make a difference!
What we offer:
Competitive compensation
Benefits start on your 1 st 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 Program
JOB SUMMARY:
Reimbursement Audit Representative is responsible for evaluating, tracking, auditing, and monitoring processes as they relate to billing to assure accurate claims and compliance.
DUTIES & RESPONSIBILITIES:
Acts as a liaison between the reimbursement department and various other departments throughout the organization to audit, monitor, track and resolve reimbursement issues.
Responsible for managing audit request from payers assuring all required documentation is on file and submitted by the deadline for successful results.
Responsible for tracking and monitoring all Payer request audit for the entire organization and reporting to Director of Reimbursement or other management team members.
Responsible for auditing and managing the Billing Review of new accounts for accurate initial set up of patient accounts with insurance, eligibility, authorization, Start of Care forms, diagnosis, and prescriptions.
Audit's pharmacy online claims for accuracy and correct claim submission for accurate reimbursement
Assures billing processes are compliant with payer requirement for Government, Commercial Health Plans and Medical Group payers.
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.
PREFERRED SKILLS & EXPERIENCE:
High School Diploma or equivalent education.
Candidate must be experienced with a minimum of 1-2 years (not including school or externship) in Home Infusion.
Licensed Pharmacy Technician (preferred)
Knowledge and understanding of HCPC and CPT codes

#corporate #reimbursement #audit #infusion #homeinfusion #healthcare #cpt #hcpc #managedcare #payors #reimbursement #claims #collections #kabafusion #nowhiring

PI179445659

Keywords: KabaFusion, Cerritos , Reimbursement Audit Representative, Accounting, Auditing , Cerritos, California

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