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Infusion and Specialty Drug Revenue Cycle Specialist
House + Home LoansInfusion and Specialty Drug Revenue Cycle Specialist managing accounts receivable processes related to physician-administered drugs. Collaborating with pharmacy teams and insurance companies for efficient revenue cycle management.
About the role
Key responsibilities & impact- 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
What you’ll need- 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
Comp & perks- Health insurance
- Flexible work arrangements
- Professional development opportunities
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Medical TerminologyHCPCS CodingClaims ProcessingReimbursement ProceduresPrior AuthorizationAR Follow-UpDetail OrientationAnalytical Thinking
Soft Skills
Effective CommunicationOrganizational SkillsCustomer Service Orientation