Reimbursement Audit Representative

Company: KabaFusion
Location: Cerritos
Posted on: May 14, 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 PI175254143

Keywords: KabaFusion, Cerritos , Reimbursement Audit Representative, Other , Cerritos, California