Reimbursement Manager (Remote)

About Local Infusion

When a patient is diagnosed with a chronic autoimmune disease, they learn that managing their disease will be a lifetime responsibility. Their whole care experience is broken. The cost, the confusion, the antiquated technology. Patients sit in cold, fluorescent-lit rooms, for several hours at a time, multiple times a year for the rest of their lives! Outside of the room, the experience isn't any warmer. Inaccurate medical bills. A lack of communication. A referral process that's lengthy and daunting. For patients and their families, this isn't just treatment—this is their life.

Our team has spent decades in the infusion and healthcare industry. We saw all the mistakes the industry was making. At every step, we thought, "there has to be a better way."  Local Infusion is a thriving healthcare organization currently operating four rapidly growing centers throughout Maine,New Hampshire, Connecticut, New Jersey & Virginia. Our success in the specialty infusion field is driving the addition of more clinics, which will be opening over the next 12 months. As the Reimbursement Manager, you'll play a vital role in optimizing our financial processes across all locations, contributing to our dynamic expansion in new markets.  

Come be a part of that solution and join a team that is passionate about connecting patients to the life saving care they need!

Position Overview:

Local Infusion is seeking an experienced and detail-oriented Revenue Cycle professional to execute and troubleshoot all revenue cycle functions within the ambulatory infusion centers including but not limited to cash posting, billing, and collections functions.  This position will work closely with the senior leadership team. The successful candidate will play a crucial role in optimizing revenue processes, and maintaining efficient financial operations. If you possess a strong background in billing, collections, and cash posting, along with a comprehensive understanding of infusion claims, this role offers an exciting opportunity to contribute to the success of our rapidly growing organization.

Responsibilities:

• Sole owner of cash posting, billing, and collections functions for Local Infusion's specialty infusion services.

• Analyze financial data to identify trends, discrepancies, and opportunities for process improvement.

• Ensure accurate and timely submission of claims, invoices, and statements to payors and patients.

• Collaborate with internal teams to resolve billing and payment discrepancies and address outstanding balances.

• Maintain a comprehensive understanding of fee schedules, payor policies, and managed care contracts, including Medicare and Medicaid.

• Monitor compliance with regulatory standards, including Medicare compliance, OSHA, and HIPAA, and implement necessary measures to ensure adherence.

• Utilize NaviNet, Availity, payer portals, and other relevant tools to facilitate efficient claims processing and communication with payors.

• Demonstrate proficiency in ICD-10, CPT, HCPCS coding, referrals, pre-certification procedures, and documentation guidelines.

• Provide guidance and training to team members regarding revenue cycle processes and compliance requirements.

• Foster positive relationships with payors, patients, and internal stakeholders to optimize revenue collections and resolve issues promptly.

• Troubleshoot and solve issues related to revenue cycle and denial claims management 

• This position will report to the Head of Strategic Finance

• Will be responsible for other duties as assigned including hiring and training necessary additional support staff. 

Requirements:

• High school diploma or GED required

• Minimum of five (5) years of billing, collections, and cash posting experience in the specialty infusion or oncology healthcare setting

• Strong analysis and analytical skills, complex problem solver and critical thinking skills required

• Advanced knowledge of regulatory and compliance regulations

• Comprehensive understanding of fee schedules, payor policies and managed care contracts, including Medicare and Medicaid

• Working knowledge of Medicare compliance, OSHA, and HIPAA

• Familiarity with NaviNet and Availity, as well as payer portals.

• Strong working knowledge of ICD-10, CPT, HCPCS, referrals and pre-certification procedures, as well as documentation guidelines

• Proficiency with standard office software applications

• Superior interpersonal communication skills, with the ability to develop and maintain effective relationships with a variety of both internal and external teams

• Strategic thinker who has desire to go above and beyond what is required, exhibits ownership, and dedication to the team and company’s success 

• Remote but must be able to travel to local office in Nashville once per month and be located in the eastern or central time zone.