Medical Billing Specialist

Company: KabaFusion
Location: Cerritos
Posted on: June 23, 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:
The Medical Billing Specialist is responsible for accurate claims submission and accurate payment of claims according to payor guidelines.
DUTIES & RESPONSIBILITIES:
Exhibits the ability to prioritize, multi-task and meet daily productivity and month-end closing deadlines.
Understands eligibility, benefits, authorization verification for treatments, complex payer contract terms, fee schedule for all payers.
Verifies that the services and products are correctly authorized.
Ensures accuracy and appropriateness of claim type, diagnosis codes, place of service, procedure codes, HCPC or NDC units for drugs, per diem, proper use of modifiers, and dates of service as defined by government payers and contracted plans.
Certifies the accuracy and completeness of payer requirements prior to timely submission of clean claims to various insurance companies, either through an electronic or hard copy.
Manages Billing Que status code to track unbilled delivery ticket(s) and maintains Reimbursement Pending Item Report, facilitates resolution, and ensures timeliness of claims submission.
Actively communicates status of assigned work, escalated billing concerns and challenges that could affect claims submission and processing with the Supervisor/Manager.
Collaborates with pharmacy to ensure rejected claim correction is resolved timely and has payable status in Claims to Adjudicate queue
Manage Billing Que to create and process claims in accordance with departmental expectations.
All efforts to obtain the Billing Requests, documents from the other respective departments will be recorded in the billing note.
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 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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PI179445653

Keywords: KabaFusion, Cerritos , Medical Billing Specialist, Healthcare , Cerritos, California