Insurance Claims Specialist
Posted on: August 6, 2022
KabaFusion is a home infusion company with exceptional
employees! KabaFusion is a home infusion company with a national
network of pharmacist owned pharmacies with the ability to service
40+ states. While we are known for our expertise in IVIg and SCIg,
we also provide 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: The Insurance Claims
Specialist is responsible for the accurate resubmission of unpaid
claims and the collection of payment of those claims according to
the payor's guidelines. DUTIES & RESPONSIBILITIES:
- Analyze and rectify claims issues with payers by timely follow
up of claim status/payment.
- Reviews and assures claims are processed and paid in full
according to contractual agreements.
- Ensures revenue is booked according to appropriate contract
- 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.
- Handles collections calls promptly with professionalism to
payers and/or patients.
- Must be able to prioritize, multi-task, meet goals and
- Protects patient health information by following regulations
for HIPAA compliance.
- Ensures daily productivity is met and monthly and monthly
closing goals are met.
- Meet and Maintain Cash Collection Goals and Metrics on a daily
and monthly basis.
- Timely Review of Remittance Advice/Correspondence; take
appropriate steps to appeal non-payment of claims.
- Utilize payer websites as resources to manage claim status and
- Report to Manager on any reimbursement issues resulting in
non-payment. PREFERRED SKILLS & EXPERIENCE:
- Strong understanding of insurance terms, medical terminology,
pricing methodologies for commercial and government billing
- Knowledge and understanding of HCPC and CPT codes
- High School Diploma or equivalent education.
- Minimum 1 year of experience collecting from payors (health
plans, medical groups and pharmacy benefits managers)
Keywords: KabaFusion, Cerritos , Insurance Claims Specialist, Other , Cerritos, California
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