Remote: Infusion Accounts Receivable Specialist

About IKS: www.ikshealth.com

Founded in 2006, IKS Health enables providers to provide better, safe, and more efficient care at scale. With over 12,000 employees, including over 1,500 physicians, and technologists, IKS Health provides solutions for over 150,000 providers across some of the largest and most prestigious healthcare provider groups in the country. Through our Provider Enablement Platform, IKS Health provides a strategic blend of technology and expertise with the aim of restoring joy and viability to the practice of medicine by giving providers the tools and resources they need to focus on what matters most – the patient. We offer clinical, financial and administrative healthcare solutions for improved operational efficiency, better patient outcomes, optimized productivity, and revenue.

Job Summary:

The Infusion Accounts Receivable Specialist will focus on the complete revenue cycle for infusion therapy services. This role involves managing billing for specialty meds, handling insurance claims (Medicare, Medicaid, Commercial), posting payments, denial management, patient collections, and reconciling discrepancies, requiring deep knowledge of healthcare billing codes (UB-04, HCPCS) and payer-specific rules to maximize timely revenue for complex infusion therapies.

Core Responsibilities

• Claims Management: Prepare, submit, and track medical claims (often using Form HCFA 1500) to Medicare, Medicaid, and commercial insurance payers.
• Denial Resolution: Research and resolve denied or rejected claims within specific timeframes (e.g., within 5 days of receipt) to ensure maximum reimbursement.
• Aging A/R Monitoring: Actively follow up on outstanding balances, typically focusing on accounts aged past 45 or 90 days to meet departmental cash collection goals.
• Payment Posting & Reconciliation: Verify payments from electronic remittance advice (ERA) or Explanation of Benefits (EOB), and reconcile accounts to ensure mathematical accuracy.
• Payer Communication: Maintain regular contact with insurance carriers to troubleshoot payment discrepancies and negotiate payment plans with patients.
• Regulatory Compliance: Adhere to strictly mandated healthcare regulations, including HIPAA guidelines for patient data privacy.

Specialized Infusion Knowledge

• Coding: Understanding of infusion-specific CPT codes (e.g., 96413, 96365, 96372) and National Drug Code (NDC) numbers.
• Documentation Review: Identifying non-compliance in supporting clinical documentation, such as delivery tickets or patient registration, which could delay billing.
• Drug Terminology: Basic knowledge of infusion therapies, drug supplies, and metric quantities required for accurate billing.

Qualifications and Skills

• Experience: Often requires 1–5+ years in healthcare billing or collections; specific experience in home infusion, oncology, or specialty pharmacy is highly preferred.
• Technical Skills: Proficiency in healthcare software (e.g., EPIC, Allscripts, or Brightree RCM) and advanced Excel tools for reporting. Familiarity with Medicare, Medicaid, and Commercial payer guidelines.
• Attention to Detail: Critical for identifying billing errors and ensuring correct demographic data to reduce claim rejections.
• Education: Typically requires a High School Diploma or GED; some positions prefer a Bachelor's degree for lead roles.

Compensation and Benefits:

The hourly pay range for this position is $28 - $30 per hour. Pay is based on several factors, including but not limited to current market conditions, location, education, work experience, certifications, etc. IKS Health offers a competitive benefits package including healthcare, 401(k), and paid time off (all benefits are subject to eligibility requirements for full-time employees). IKS Health is an equal opportunity employer and does not discriminate based on race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status.