Insurance Claims Specialist
Posted on: August 7, 2022
KabaFusion is a home infusion company with exceptional
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:
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
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
Must be able to prioritize, multi-task, meet goals and
Protects patient health information by following regulations for
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
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
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)
#corporate #collections #healthplan #medicalgroups
#pharmacybenefitmanagers #pbm #finance #reimbursement #kabafusion
Keywords: KabaFusion, Cerritos , Insurance Claims Specialist, Other , Cerritos, California
Didn't find what you're looking for? Search again!