Billing Specialist

🔥 2 minutes ago

🇺🇸 United States – Remote

💵 $20 - $23 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

📊 Billing Specialist

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Soleo Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare • Healthcare Insurance • Pharmaceuticals

Soleo Health is a specialty pharmacy company that goes beyond simply filling prescriptions by providing personalized patient experiences and access to specialized medications and infusion therapies. They offer treatment in patients' homes, in providers' offices, or at one of their many nationwide infusion centers. Soleo Health specializes in treating complex and ultra-rare diseases with a focus on improving patient quality of life and optimizing health outcomes. They work closely with patients, providers, pharmaceutical manufacturers, payors, and health systems to deliver high-cost therapies, demonstrating value through real-world outcome data. Soleo Health is recognized for its clinical excellence and dedication to patient care, and offers nationwide services, including an online portal, Soleo Connect®, for real-time communication.

📋 Description

• Support Soleo Health's Specialty Infusion Pharmacy • Primarily handle insurance and self-pay billing, excluding Medicare • Submit electronic and paper claims • Follow up with clearing house vendors on accepted and working rejections • Prepare accurate medical claims for commercial, government, employer, and institutional payers • Review claims pricing discrepancies based on fee schedule updates or changes • Create and submit secondary electronic pharmacy and medical claims • Bill manufacturer copays through portals or paper billing • Monitor billing requirements under payer contracts and government programs • Answer insurance and billing questions from branch staff and provide education • Review electronic medical records to prepare and submit clean claims • Perform monthly revenue review of billed claims • Answer incoming calls and triage when necessary • Create claim batches and process electronic submissions • Manually process claims ineligible for electronic billing • Identify, correct, and resubmit claims needing attention • Ensure coding specificity for maximum third-party reimbursement • Review and follow up daily on unbilled delivery tickets • Accurately document actions in patient accounts • Coordinate with the pharmacy team to resolve PBM issues and ensure timely billing • Meet performance goals through effective use of time and resources • Provide customer service to internal and external customers • Ensure compliance with government requirements, payer contracts, and company policies • Communicate billing issues to Intake, collections, RBL, and management • Monitor unbilled-pending invoice queues and communicate missing information to branches • Maintain current knowledge of departmental and organizational policies

🎯 Requirements

• 2 years of home infusion billing experience is required • High School Diploma or equivalent • Knowledge of HCPC coding and medical terminology • Experience providing customer service to internal and external customers • Must be computer literate • Must be dependable • Excellent phone and email communication skills • Working knowledge of ICD10, CPT, NCCI; must be familiar with modifier application and standard billing regulations • Work Remotely (USA)

🏖️ Benefits

• Competitive Wages • 401(k) with a Match • Referral Bonus • Paid Time Off • Great Company Culture • Annual Merit Based Increases • No Weekends or Holidays • Paid Parental Leave Options • Affordable Medical, Dental, and Vision Insurance Plans • Company Paid Disability and Basic Life Insurance • HSA and FSA (including dependent care) Options • Education Assistance Program • Monday - Friday, 8:30am - 5pm