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Billing Specialist

Syracuse, New York, United States; United States – Remote

BioMatrix is a nationwide, independently-owned infusion pharmacy with decades of experience supporting patients on specialty medication. Our compassionate care team helps patients navigate the often-challenging healthcare environment. We treat our patients like family and get them started on therapy quickly. We work closely with them as well as their family and their healthcare providers throughout the patient journey, staying focused on optimal clinical outcomes.

 

At BioMatrix the heart of our Inclusion, Diversity, Equity, & Access (IDEA) philosophy is the commitment to cultivate a welcoming space where everyone’s contributions are acknowledged and celebrated. Our goal is to draw in, develop, engage, and retain talented, high-performing individuals from diverse backgrounds and viewpoints. We believe that both respecting and embracing diversity enriches the experiences and successes of our patients, employees, and partners.

 

Schedule & Location:

Monday Through Friday Between 8:00 am Eastern Standard Time & 5:00 pm Eastern Standard Time. It is anticipated that an incumbent in this role will work on site Syracuse, NY or remotely. 

 

Job Description:

The Billing Specialist is responsible for verifying that all appropriate prescription reimbursement data has been obtained, entered into the system and is accurate weekly and prior to month end. Processes electronic pharmacy insurance claims to Medicare D, Medicaid, and Commercial Insurance. Assures the timely and accurate submission of invoices to the responsible payer for services and products provided, and evaluates payments received for final resolution and application to the patient account.

QUALIFICATION REQUIREMENTS
  • GED or high school diploma required
  • Minimum of two (2) years of working experience in medical billing & collection related activities required
  • Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.
  • Basic level skill in Microsoft Office (including Word, Excel, PowerPoint, etc.).  

QUALIFICATIONS PREFERRED
  • Minimum of five (5) years of working experience in medical billing & collection related activities preferred
  • Previous home infusion therapy billing experience preferred
  • Experience with CareTend or CPR+ preferred

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
  • Prepare and submit insurance claims for home infusion services, including nursing, supplies, and medications.
  • Verify documentation of supplied products align with prepared claim.
  • Verify accuracy of billed codes and accuracy of billed and expected amounts.
  • Have a thorough understanding of payer contracts. 
  • Understanding the different types of home infusion medications and therapies. 
  • Knowledge of insurance verification and reimbursement processes. 
  • Address customer inquiries and resolve billing discrepancies, providing excellent customer service to both internal and external stakeholders.
  • Stay updated on relevant billing regulations, coding guidelines, and payer requirements, ensuring compliance with all applicable standards. 
  • Familiarity with clearinghouses and the billing functionality. 
  • Assist with various data entry, administrative, and clerical tasks. 

KNOWLEDEGE, SKILLS AND ABILITIES REQUIREMENTS
  • Able to stay abreast of payer alerts and reimbursement changes.
  • Able to work in a fast-paced environment.
  • Able to navigate and interpret insurance contracts.
  • Ability to actively communicate, inspire and motivate all levels of staff.
  • Ability to think and act strategically and proactively.
  • Ability to maintain accurate records and prepare reports and correspondence related to the work. 
  • Ability to organize and coordinate the work of others. 
  • Ability to set priorities and assign work to other professionals.
  • Excellent analytical skill.

Communication Skills 

  • Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings. 
  • Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information. 

Computer Skills 

Become and remain proficient is all programs necessary for execution.

 

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. If needing a reasonable accommodation within the application process, please contact the BioMatrix People & Culture team at Careers@BioMatrixsprx.com or 954.385.7322 x 1425.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

OTHER

  • Will participate in legal and ethical compliance training each year.
  • Will consistently behave in compliance with the BioMatrix, LLC’s legal and ethical policies and procedures.
  • Will abide by the policies of BioMatrix, LLC as set forth in the Compliance Manual.
  • Will not participate in any conduct considered to be unethical or illegal.

EXPECTATION FOR ALL EMPLOYEES

Supports the organization's mission, vision, and values by exhibiting the following behaviors: integrity, dedication, compassion, enrichment and enthusiasm, places patients first, is all-in with stacked-hands, and is focused on relentless consistency wins.

GENERAL INFORMATION:

The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required of personnel so classified.

The incumbent must be able to work in a fast-paced environment with demonstrated ability to juggle and prioritize multiple, competing tasks and demands and to seek supervisory assistance as appropriate.

Incumbents within this position may be required to assist or find appropriate assistance to make accommodations for disabled individuals in order to ensure access to the organization's services (may include: visitors, patients, employees, or others).

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

 

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