Infusion Drug Billing Specialist

Position Summary

The Infusion Drug Billing Specialist is responsible for the accurate and timely preparation and submission of insurance claims for infusion medications and related services provided by a home infusion pharmacy. This position works closely with intake, authorization, pharmacy, and clinical teams to ensure billing information is complete, accurate, and compliant with payer requirements. The ideal candidate will have experience billing infusion therapies and specialty medications to commercial, Medicare, and Medicaid payers.

Essential Duties and Responsibilities

• Prepare and submit clean claims for infusion medications and related services.

• Accurately apply HCPCS, CPT, ICD-10, and NDC information as required.

• Verify payer-specific billing requirements and ensure claims comply with reimbursement guidelines.

• Review authorizations and supporting documentation to ensure billing accuracy.

• Identify and correct claim errors prior to submission.

• Submit corrected claims when claims are rejected due to billing or coding errors.

• Collaborate with admissions, RCM, pharmacy, and clinical staff to obtain missing information necessary for billing.

• Maintain accurate documentation within pharmacy and billing systems.

• Monitor billing work queues to ensure claims are submitted within established timelines.

• Stay current on payer billing requirements and industry regulations related to home infusion services.

• Comply with HIPAA, accreditation standards, and company policies and procedures.

Qualifications

Required

• High School Diploma or GED required.

• Minimum of 2 years of medical billing experience.

• Minimum of 1 year of home infusion pharmacy, specialty pharmacy, or infusion billing experience.

• Knowledge of Medicare, Medicaid, and commercial payer billing requirements.

• Experience utilizing HCPCS, CPT, ICD-10, and NDC codes.

• Strong attention to detail and accuracy.

• Excellent organizational and time-management skills.

• Proficiency in Microsoft Office applications and billing systems.

Preferred

• Home infusion pharmacy billing experience.

• Knowledge of infusion therapies.

• Experience with electronic claims submission and clearinghouse platforms.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• The employee may be frequently required to stand, sit, walk, see, hear; use hands and fingers regularly, handle, or feel objects, tools, or controls, reach with hands and arms, bend at the knees and waist - such as to access equipment.

• The employee may frequently lift and/or move, push and pull equipment, up to 5 pounds and may occasionally lift and/or move up to 15 pounds.

Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. This job description reflects management's assignment of essential functions; it does not prescribe or restrict the tasks that may be assigned.

At Basic Home Infusion, we are deeply committed to promoting diversity, equity, and inclusion in our provision of intrathecal infusion pain management services. We recognize that these core values are essential for achieving optimal patient outcomes and creating a supportive and inclusive environment for our team members.