Billing Specialist - RCM

Vital Care Infusion Services•Pittsburgh, PA

4d•Remote

About The Position

Vital Care is seeking a Billing Specialist for its Revenue Cycle Management (RCM) team. This role focuses on processing Home Infusion medical claims with an emphasis on accuracy, timeliness, and adherence to processes to minimize denials, Days Sales Outstanding (DSO), and bad debt. The position involves performing revenue cycle billing duties within standard compliance practices and is a 100% remote role.

Requirements

Excellent communications skills; listening, speaking, understanding, and writing English while influencing patients, caregivers, payer representatives, and others, answering questions, and advancing reimbursement and collection efforts.
Proven understanding of processes, systems, and techniques to ensure successful billing and collection working with all payer types.
Proven ability to identify gaps and problems from a review of documentation, determine lasting solutions, make effective decisions, and take necessary corrective action.
Strong organization skills with the ability to track and maintain clear, complete records of activities, cases, and related documentation.
Proven knowledge and skill in the utilization of MS Office suite of software and pharmacy applications.
Ability to complete job duties in a designated workspace outside the dedicated RCM location.
Disciplined work ethic with ability to work remotely with little direct supervision and meet production and collection targets.
2-5 years home infusion billing and/or collections experience required.
High School Diploma and additional specialized training in intake, pharmacy/medical billing, and/or collections.

Nice To Haves

Experience in an infusion suite setting is a plus.
Previous remote work environment is a plus but not required.
Detailed oriented with post-billing and post-payment investigative experience preferred.

Responsibilities

Create and submit medical, pharmacy and third-party vendor claims timely and accurately.
Ensure all revenue opportunities are included, and complete and submit billing to primary and secondary payers.
Resolve rejected electronic claims so that current submission is successful and future submissions are not rejected.
Maintain ready-to-bill delivery tickets and indicate tickets that cannot be billed with appropriate status for communication purposes within RCM and Franchises.
Document case activity, communications, and correspondence in CareTend to ensure completeness and accuracy of account activity.
Contribute medical billing expertise to the design of training and knowledge transfer programs, materials, policies, and procedures to improve the efficiency and effectiveness of the RCM team.
Perform other related duties as assigned.