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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in home infusion revenue cycle management, including proficiency in Federal and State billing guidelines, and the ability to conduct thorough quality audits and training. Strong communication and problem-solving skills are essential for resolving discrepancies and ensuring compliance with payer requirements.
Highest-signal resume keywords
Home Infusion Revenue Cycle ManagementFederal And State Billing GuidelinesQuality AuditsCPR+ SoftwareICD-10, CPT-4, HCPCS Billing
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Quality AuditsClaim Denial AuditsBilling GuidelinesMedical TerminologyMicrosoft Office SuitePayer AuditsAttention To DetailProblem-SolvingTraining DevelopmentRoot Cause Analysis
Soft Skills
Excellent Communication SkillsCustomer Service OrientationInterpersonal SkillsOrganizational SkillsAbility To Multitask
Tools & Technologies
CPR+ Software
Certifications & Qualifications
High School DiplomaGED
Industry Keywords
MedicareMedical AssistanceHighmarkUPMC Health PlanHome Infusion
About the role
Key responsibilities & impact- Prioritize and complete all assigned tasks
- Complete payer audits in a timely manner and before deadlines
- Maintain current knowledge of state and federal guidelines and payer requirements, including Medicare, Medical Assistance, Highmark, and UPMC Health Plan
- Perform quarterly quality audit checks
- Complete quality audits on new employees until the accuracy threshold is met
- Perform claim denial audits
- Complete ongoing quality focus audits on billing and collection activity
- Assist with training on recurring errors found during quality audits
- Assist in developing Standard Operating Procedures
- Complete special projects as requested
- Perform in accordance with system-wide competencies and behaviors
- Review claim submissions for accuracy and identify root causes of claim issues
- Resolve discrepancies and share findings with leadership
Requirements
What you’ll need- High School diploma or GED required
- Proficiency in the Microsoft Office Suite
- 3+ years of experience in home infusion revenue cycle
- Strong knowledge of Federal and State billing guidelines
- Working knowledge of basic medical terminology required
- Excellent verbal and written communication skills
- Strong customer service orientation
- Excellent problem-solving skills
- Strong interpersonal and organizational skills, with the ability to work on multiple tasks simultaneously with attention to detail
- Experience with CPR+ Software
- Experience with ICD-10, CPT-4, HCPCS, and Medicare billing is preferred
- Home internet connection through a cable broadband or fiber optic internet service provider, with speeds of at least 10Mbps download/5Mbps upload, if working from home
Benefits
Comp & perks- Annual bonus plan eligibility
- Medical, vision, and dental benefits
- Well-being and behavioral health programs
- 401(k)
- Company-paid life insurance
- Tuition reimbursement
- Minimum of 18 days of paid time off per year
- Paid holidays
- Leaves of absence
- Remote work option
- Cable broadband or fiber optic internet requirement for home working, with at least 10Mbps download/5Mbps upload