Home Infusion Billing Specialist

AIS Healthcare•Remote,

9d•Remote

About The Position

Advanced Infusion Care (AIC) is a leading provider of home infusion and IG therapy, serving patients through six pharmacy locations. Guided by our values of Innovation, Stewardship, and Unity, we are committed to advancing quality and improving lives through exceptional products, services, and patient care. AIC offers a comprehensive benefits package, including medical, dental and vision insurance, long-term disability, life insurance, paid time off, and a 401(k) plan with a generous employer match. Advanced Infusion Care is seeking an experienced and detail-oriented Infusion Billing Specialist to join our Financial Services team. The Infusion Billing Specialist is responsible for accurate and timely billing activities from delivery ticket confirmation through submission of electronic and paper HCFA 1500 claims to third-party payers. This position works closely with Pharmacy, Collections, and other Revenue Cycle Management teams to resolve billing issues and support timely reimbursement. The ideal candidate has strong healthcare billing knowledge, home infusion experience, excellent problem-solving skills, and the ability to work independently while maintaining compliance with applicable federal and state regulations, payer requirements, company policies, and HIPAA.

Requirements

High school diploma or GED required.
Minimum of 5 years of healthcare industry experience required.
Home infusion billing experience required.
Strong knowledge of healthcare reimbursement and third-party payer requirements.
Knowledge of medical terminology required.
Working knowledge of ICD-10 coding.
Strong understanding of Revenue Cycle Management and how its functions integrate across the billing and collections process.
Strong analytical and problem-solving skills with the ability to make timely, sound decisions.
Exceptional attention to detail and accuracy.
Excellent written and verbal communication skills.
Ability to establish effective working relationships with internal and external stakeholders.
Ability to prioritize and manage multiple responsibilities in a fast-paced environment.
Strong work ethic, integrity, accountability, and professionalism.
Self-directed, organized, dependable, and able to follow through on assigned responsibilities.
Ability to handle sensitive and confidential information appropriately.
Proficiency with Microsoft Office, including Outlook, Word, and Excel.

Nice To Haves

Medical coding knowledge and experience preferred.
Knowledge of NDC numbers, metric quantities, and infusion supplies preferred.
Experience with Waystar or similar claims-management platforms preferred.

Responsibilities

Review and follow up on open pharmacy delivery tickets to ensure timely and accurate billing.
Monitor and resolve claims identified on billing hold reports.
Prepare and submit accurate electronic and paper HCFA 1500 claims.
Work rejected claims queues in Waystar and resolve issues for timely resubmission.
Research and submit corrected claims as needed.
Respond timely and accurately to questions from the Collections team and other internal departments.
Review claims for billing accuracy, including payer requirements, coding, NDCs, units, quantities, and infusion supplies.
Maintain working knowledge of payer policies, reimbursement requirements, medical terminology, and applicable billing regulations.
Identify billing issues and use sound judgment to determine appropriate resolution.
Maintain accurate and thorough documentation of billing activities.
Protect patient information and maintain strict confidentiality in accordance with HIPAA and company policies.
Recognize and respect patient rights, privacy, and confidentiality in the performance of all job duties.
Maintain compliance with federal and state laws, regulations, payer requirements, and company policies.
Perform other duties as assigned.