Claims Audit Representative
Posted on: September 20, 2022
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
- Employee Referral Program JOB SUMMARY: responsible for
evaluating, tracking, auditing, and monitoring processes as they
relate to billing to assure accurate claims and compliance. DUTIES
- 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
- 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
- Communicates and addresses reimbursement issues with management
for resolution in a timely manner.
- Must be able to prioritize, multi-task, meet goals and
- 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
Keywords: KabaFusion, Cerritos , Claims Audit Representative, Accounting, Auditing , Cerritos, California
Didn't find what you're looking for? Search again!