Physician Biller with infusion billing experience

American River Healthcare•Sacramento, CA

4d•Onsite

About The Position

American River Visiting Providers is looking for a physician biller with hands on infusion billing experience to manage physician billing, collections, and specialty infusion billing and collections. This role sits at the center of our revenue cycle and also carries a patient facing responsibility, so the right person combines strong billing knowledge with a warm, clear communication style. This position works closely with clinical and front office teams to keep claims accurate, resolve denials quickly, and give patients a smooth billing experience.

Requirements

Two or more years of physician billing experience, required.
Direct experience with specialty infusion billing and collections, required.
Working knowledge of Medicare and Medi-Cal billing rules for physician and infusion services.
Familiarity with CPT, HCPCS, ICD 10, and J code billing for infused medications.
Experience with prior authorization processes for infusion therapies.
Understanding of Medicare coverage criteria for infused medications, including required labs and supporting documentation.
Comfortable speaking with patients directly about balances, statements, and payment options.
Strong organizational skills and attention to detail when managing multiple accounts.
Clear written and verbal communication skills.

Nice To Haves

Experience with Athena platform preferred.

Responsibilities

Prepare, submit, and track physician professional claims for Medicare, Medi-Cal, and commercial payers.
Manage specialty infusion billing and collections, including prior authorization follow up, J code and HCPCS accuracy, and payer specific infusion billing rules.
Work accounts receivable for physician and infusion services, following up on unpaid and underpaid claims until resolution.
Research and resolve claim denials and rejections, correcting and resubmitting claims within payer timelines.
Review coding and documentation for billing accuracy, coordinating with providers and coding staff as needed.
Serve as a patient facing point of contact for billing questions, payment plans, and statement disputes, delivering every interaction with patience and professionalism.
Verify insurance benefits and eligibility for physician and infusion visits when needed to support clean claims.
Verify Medicare eligibility and confirm patients meet Medicare coverage criteria for infused medications before billing.
Monitor that required lab work is received and on file to support medical necessity for infusion therapies.
Confirm that orders from the referring physician are valid, current, and properly signed before products are orders and services are billed.
Post payments, adjustments, and denials accurately, and reconcile accounts against remittance advice.
Track key collections metrics and flag trends or payer issues to leadership.
Maintain compliance with Medicare, Medi-Cal, and payer billing regulations, including timely filing and documentation standards.