Infusion and Specialty Drug Revenue Cycle Specialist

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🤠 Texas – Remote

🤠 Texas – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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House + Home Loans

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2001

💳 Fintech

📚 Education

🏦 Banking

Fintech • Education • Banking

House + Home Loans is a financial service company that specializes in providing student loans and scholarships for Texas residents seeking higher education. Through various loan programs, including low-interest options and forgiveness plans, House + Home Loans aims to support students in completing their degrees and certifications in several fields. The company collaborates with the Texas Higher Education Coordinating Board to deliver accessible financial resources and guidance for managing education-related debt, thus empowering students to achieve their educational and career goals.

📋 Description

• Submit accurate claims for infusion therapies, injectable medications, and physician-administered drugs to insurance payers • Track claims to ensure timely processing and reimbursement • Identify and address claim rejections and denials promptly • Reconcile payments and outstanding balances for infusion and injectable drug claims • Maintain detailed records of payer communications and payment status • Confirm insurance eligibility and coverage for infusion therapies and physician-administered drugs • Collaborate with pharmacy and clinical teams to obtain prior authorizations when required • Ensure claims comply with payer policies, coding standards, and regulations • Maintain organized and accurate documentation for audit purposes • Identify opportunities to optimize the infusion and medical benefit drug billing process

🎯 Requirements

• High School Diploma or equivalent (higher degree accepted) • 2 years of experience in infusion billing, buy-and-bill processes, specialty pharmacy billing, or medical benefit drug reimbursement • Experience in oncology, rheumatology, or infusion center settings is highly desirable • 1 year Familiarity with specialty pharmacy operations is a plus • Advanced knowledge of medical terminology, ICD 10, CPT, HCPCS coding and HIPAA requirements • Ability to communicate effectively, both orally and in writing • Demonstrated proficiency in the use of computer and commonly used software, including electronic medical records (EMR) • Extensive knowledge and experience with commercial, government and state billing and reimbursement procedures • Proficiency in insurance verification, prior authorization, and AR follow-up • Attention to detail, organizational skills, customer service orientation, and analytical thinking

🏖️ Benefits

• Health insurance • Flexible work arrangements • Professional development opportunities