The Lead Infusion Reimbursement Specialist is responsible for providing thought leadership, quality assurance, and advanced expertise in billing and collections within Prochant’s Infusion Division. In addition to managing reimbursement tasks, the lead infusion reimbursement specialist acts as a mentor and trainer for other reimbursement specialists, supporting their professional growth and development. Serving as a liaison between reimbursement specialists and the Reimbursement Manager, they help streamline operations, resolve challenges, and assist with complex projects. This position is crucial in fostering a collaborative, high-performing team environment while supporting the division’s strategic growth objectives. Responsibilities include but are not limited to:
- Overseeing timely and accurate processing of infusion reimbursement claims, ensuring clean claim submission and follow-up with health plans.
- Utilizing billing software, payer portals, and data reporting tools to manage outstanding A/R and enhance cash collections.
- Mentoring and training reimbursement specialists, providing guidance on best practices and strategies for resolving billing challenges.
- Acting as a liaison between team members and management, assisting with escalated client concerns, and freeing up manager time.
- Conducting quality assurance checks to ensure claim accuracy, compliance, and efficiency in reimbursement processes.
- Proactively identifying potential roadblocks affecting clients or Prochant, escalating or resolving them in a timely manner.
- Maintaining strong relationships with clients, responding to inquiries with professionalism and clarity.
- Prioritizing responsibilities, managing workload effectively, and adapting to changing priorities while maintaining focus on deadlines.
- Collaborating with offshore teams and participating in efforts to support organizational needs.
Requirements
- High School diploma or equivalent required.
- Minimum 2 years of experience in home infusion billing and collections.
- Experience using Brightree, CPR+, CareTend, or WeInfuse software preferred.
- Strong written and verbal communication skills with an ability to mentor and train others.
- Demonstrated initiative and problem-solving ability
- Deep knowledge and experience billing and collecting major medical claims for home infusion, ambulatory infusion, and/or specialty pharmacy.
- Ability to demonstrate a clear understanding of CMS 1500 and 837 claim formatting and billing process.
Benefits
Prochant offers some of the best benefits in the industry! We take great care of our employees. Prochant’s Fortune 500 level benefits package includes:
- Health Insurance
- Gap Insurance
- Dental Insurance
- Vision Insurance
- Short Term / Long Term Disability (company paid)
- Term Life Insurance (company paid, employee can elect additional)
- Full suite of CHUBB supplemental insurance plans, including: Disability Income, Level Term Life, Accident Insurance, & Critical Illness Insurance
- Floating holidays and paid time off
- 401K with company match