Billing Specialist

Billing Specialist

Location: Houston, TX

Recognized as a “Best Place to Work Modern Healthcare” – Join a team where people come first. At Vital Care, we are committed to creating an inclusive, growth-focused environment where every voice matters.f

Vital Care is the premier pharmacy franchise business with franchises serving a wide range of patients, including those with chronic and acute conditions. Since 1986, our passion has been improving the lives of patients and healthcare professionals through locally-owned franchise locations across the United States.

We have over 100 franchised Infusion pharmacies and clinics in 35 states, focusing on the underserved and secondary markets. We know infusion services, and we guide owners along the path of launch, growth, and successful business operations.

What we offer:

• Comprehensive medical, dental, and vision plans, plus flexible spending, and health savings accounts.
• Paid time off, personal days, and company-paid holidays.
• Paid Paternal Leave.
• Volunteerism Days off.
• Income protection programs include company-sponsored basic life insurance and long-term disability insurance, as well as employee-paid voluntary life, accident, critical illness, and short-term disability insurance.
• 401(k) matching and tuition reimbursement.
• Employee assistance programs include mental health, financial and legal.
• Rewards programs offered by our medical carrier.
• Professional development and growth opportunities.
• Employee Referral Program.

Job Summary:

Perform duties to process Home Infusion medical claims with a focus on accuracy, timeliness, and adherence to process, to reduce denial rate, DSO, and bad debt. Performs revenue cycle billing duties to process within the limits of standard Compliance practices.

Position is 100% remote.

Duties/Responsibilities:

• Create and submit medical, pharmacy and third-party vendor claims timely and accurately. Ensure all revenue opportunities are included, and complete and submit billing to primary and secondary payers.
• Resolve rejected electronic claims so that current submission is successful and future submissions are not rejected.
• Maintain ready-to-bill delivery tickets and indicate tickets that cannot be billed with appropriate status for communication purposes within RCM and Franchises
• Document case activity, communications, and correspondence in CareTend to ensure completeness and accuracy of account activity.
• Contribute medical billing expertise to the design of training and knowledge transfer programs, materials, policies, and procedures to improve the efficiency and effectiveness of the RCM team.
• Perform other related duties as assigned.

Required Skills/Abilities:

• Excellent communications skills; listening, speaking, understanding, and writing English while influencing patients, caregivers, payer representatives, and others, answering questions, and advancing reimbursement and collection efforts.
• Proven understanding of processes, systems, and techniques to ensure successful billing and collection working with all payer types.
• Proven ability to identify gaps and problems from a review of documentation, determine lasting solutions, make effective decisions, and take necessary corrective action.
• Strong organization skills with the ability to track and maintain clear, complete records of activities, cases, and related documentation.
• Proven knowledge and skill in the utilization of MS Office suite of software and pharmacy applications.
• Ability to complete job duties in a designated workspace outside the dedicated RCM location.
• Disciplined work ethic with ability to work remotely with little direct supervision and meet production and collection targets.

Education and Experience:

• 2-5 years home infusion billing and/or collections experience required.
• High School Diploma and additional specialized training in intake, pharmacy/medical billing, and/or collections.
• Experience in an infusion suite setting is a plus.
• Previous remote work environment is a plus but not required.
• Detailed oriented with post-billing and post-payment investigative experience preferred.

Physical Requirements:

• Sitting: Prolonged periods of sitting are typical, often for the majority of the workday.
• Keyboarding: Frequent use of a keyboard for typing and data entry.
• Reaching: Occasionally reaching for items such as files, documents, or office supplies.
• Fine Motor Skills: Precise movements of the fingers and hands for tasks like typing, using a mouse, and handling paperwork
• Visual Acuity: Good vision for reading documents, computer screens, and other detailed work.

This position is remote and full-time. The salary range for this position is $18.92-$23.46.