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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.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in infusion billing and medical benefit drug reimbursement, with a strong focus on compliance with coding standards and payer policies. Proficient in insurance verification and prior authorization processes, ensuring accurate claims submission and timely reimbursement.
Highest-signal resume keywords
Infusion Billing ExperienceICD 10 CodingCPT CodingHIPAA ComplianceInsurance Verification
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 TerminologyHCPCS CodingClaims ProcessingReimbursement ProceduresPrior AuthorizationAR Follow-UpDetail OrientationAnalytical Thinking
Soft Skills
Effective CommunicationOrganizational SkillsCustomer Service Orientation
Tools & Technologies
Electronic Medical Records (EMR)
Industry Keywords
Infusion TherapiesSpecialty PharmacyOncologyRheumatologyBuy-and-Bill Processes
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