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Billing Specialist
Coral ConnectBilling Specialist processing medical, pharmacy, and infusion claims for Coral Connect, a healthcare cost-reduction services provider. Ensuring accurate reimbursement through coding validation, rejection management, authorization review, and payer compliance.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical billing processes, including claim submission, rejection management, and adherence to HIPAA compliance. Proficient in handling infusion services and specialty pharmacy billing with a strong attention to detail and organizational skills.
Highest-signal resume keywords
Medical Billing ExperienceInfusion Services KnowledgeClaim Submission ProficiencyHCPCS, J-Codes, CPT, ICD-10 KnowledgeAttention to Detail
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical BillingClaim SubmissionRejection ManagementInfusion Drug ReimbursementCPT CodingICD-10 CodingHCPCS CodingModifiers KnowledgeBilling Software ProficiencyMicrosoft Excel
Soft Skills
Organizational SkillsTime ManagementAttention to Detail
Tools & Technologies
EMR SystemsPractice Management SoftwareBilling Software
Industry Keywords
Healthcare BillingInfusion ServicesSpecialty PharmacyMedicare BillingMedicaid BillingCommercial Insurance BillingBilling Regulation Compliance
About the role
Key responsibilities & impact- Review patient accounts for billing readiness and verify required documentation, authorizations, and charges
- Prepare and submit professional, facility, infusion, and pharmacy claims to payers within filing deadlines
- Validate HCPCS, J-Codes, CPT, ICD-10, modifiers, units, and place of service codes
- Bill infusion therapies, specialty pharmacy claims, and home infusion services according to payer and regulatory requirements
- Monitor claim transmission reports, clearinghouse edits, payer edits, adjudication responses, and rejections
- Research, correct, and resubmit rejected claims within established turnaround times
- Coordinate with pharmacy teams regarding prescription, dispensing, reimbursement, and coordination of benefits
- Verify prior authorizations and clinical documentation support billed services
- Review charges for accuracy and completeness, identify missing charges, and support revenue integrity
- Collaborate with intake, prior authorization, cash posting, accounts receivable, clinical, pharmacy, RCM, and client teams
- Participate in client meetings, quality assurance audits, training, special projects, and process improvement initiatives
- Maintain HIPAA and billing-regulation compliance, detailed billing documentation, and adherence to company procedures
Requirements
What you’ll need- High School Diploma or GED required
- Minimum 1 year of healthcare billing experience preferred
- Experience in infusion services, specialty pharmacy, physician billing, hospital outpatient billing, or home infusion preferred
- Experience with Medicare, Medicaid, and commercial insurance billing preferred
- Experience with infusion-specific reimbursement methodologies preferred
- Strong understanding of medical billing and reimbursement processes
- Knowledge of HCPCS, J-Codes, CPT, ICD-10, modifiers, and payer billing requirements
- Understanding of infusion drug reimbursement and administration billing
- Familiarity with specialty pharmacy billing and adjudication processes
- Knowledge of claim submission, claim edits, and rejection management
- Strong attention to detail and accuracy
- Excellent organizational and time management skills
- Proficiency with EMR, practice management, and billing software systems
- Intermediate Microsoft Excel skills
- Ability to travel on a limited basis to client locations, internal business meetings, and other locations as needed
- Ability to maintain HIPAA and applicable billing-regulation compliance
Benefits
Comp & perks- Health insurance
- Dental insurance
- Vision insurance
- Life insurance
- 401k
- Paid Time Off