ACU-Serve Corp

The Infusion Client Success Manager oversees billing functions, coordinates office efforts to expedite payment, and ensures the efficiency of reimbursement analysts. They also monitor billing and collections processes, prepare reports, and conduct performance reviews. | Candidates should have experience in medical billing, preferably in home infusion or specialty pharmacies, and hold a certification from an accredited Medical Billing Program. Proficiency in medical terminology and coding is essential, along with strong communication skills. | Duties & Responsibilities:  * Oversee the billing functions, including the initiation of goals and procedures, overseeing daily operations, and coordinating office efforts to expedite payment of accounts. * Strong customer service skills; answering calls, prompt return and follow-up to all interactions; prompt response to request for information, both internally and externally. * Identify, implement and improve billing and collections processes that will make a positive contribution to financial results. * Develop and implement goals, policies, procedures, and guidelines, which ensure the reimbursement analysts are working efficiently and maximizing reimbursement. * Monitor the effectiveness of activities to ensure authorizations, billings, postings, collections, accounts receivable and adjustments stay within established ranges. * Prepare accurate and meaningful billing, collections, accounts receivable and bad debt reports. * Report, review, maintain, and analyze all insurance reports by tracking and monitoring codes, payments, denials, and refund processes to meet compliance and performance standards. * Oversee functionality and integrity of software to ensure timely and accurate administration of electronic claims, and electronic payment remittance. * Yearly reviews for direct staff – keeping notes on their performance both good and bad  * Monthly one on one individual meetings with your direct reports * Weekly team meetings with your team to go over issues/ideas/recommendations  * Supervise Billing and AR team through effective hiring, coaching, mentoring, and performance management. Ensure development of staff to achieve high results. * Continue education in reimbursement rules, billing rules, and coding. * Bill and Collect as needed to meet goals and expectations of the clients * Work on metrics for the Reimbursement Analysts to meet monthly and monitor and enforce these goals * Conduct conference calls weekly/bi-weekly/monthly or as requested/needed by the clients * Attend yearly conferences as requested by management  * Complete daily, weekly, and monthly assignments as assigned by Management    Qualifications and skills:  Experience with medical billing for home infusion/specialty pharmacies/DME or another area of medical billing.  Candidates should possess a roll-up-your-sleeves attitude and display a willingness to work hard and be a member of the team. Building a service-oriented practice with a positive work culture is a high priority. * Graduate of an accredited Medical Billing Program and hold billing certification preferred. * WeInfuse, CPR Plus or CareTend system use preferred * Minimum of 3 years’ experience in Billing Management/Supervision is preferred * Knowledge of Microsoft Office and proficient with spreadsheets. * Proficiency in medical terminology, HCPC and ICD 10 coding. * Proficiency in filing medical claims * Expertise in reading and interpreting EOBs * Excellent Communication Skills * Commitment to goals and Philosophy of Pinnacle Revenue Management, Inc.   * HIPAA compliance knowledge

The Infusion Patient Communication Specialist is responsible for contacting patients to review their insurance benefits and clarify any out-of-pocket costs. This role also involves discussing payment options and ensuring patients understand their financial responsibilities. | A high school diploma or GED is required, along with a minimum of 2 years of experience in customer service or related fields. The candidate should possess effective communication skills and the ability to handle confidential information. | JOB DESCRIPTION Job Title: Infusion Patient Communication       Specialist  FSLA Status: Non-Exempt Department: Intake  Position Reports to: Infusion Intake Supervisor   JOB SUMMARY:   The Infusion Patient Communication Specialist is responsible for contacting patients to review their insurance benefits, explain coverage details, and clarify any out-of-pocket costs. This role involves discussing payment options, collecting outstanding balances, and setting up payment plans when needed. The representative ensures patients understand their financial responsibilities, provides exceptional customer service, and maintains accurate records in compliance with healthcare regulations and privacy standards.   REQUIRED EDUCATION AND EXPERIENCE:   A high school diploma or general education degree (GED) equivalent is required; minimum 2 years’ experience in customer service, patient communication, benefits verification, healthcare, or similar vocations.    ESSENTIAL DUTIES AND RESPONSIBILITIES:   * Notify patients and families regarding benefit coverage and financial responsibility.  * Educate patients about their insurance benefits. * Collect any financial responsibility when applicable. * Set up payment plans for patients unable to pay in full. * Document all requests, actions, and conversations in the patients record or any other utilized platforms. * Communicate effectively with patients and clients to ensure seamless coordination of care. * Provide regular status updates to the client. * Address and resolve patient concerns; escalate issues when necessary. * Promote patient satisfaction and contribute to improving the overall patient experience. * Participate in meetings and work groups to coordinate activities, discuss issues, resolve problems, and maintain current knowledge of new developments, requirements, and policies. * Comply with all regulatory requirements, company policies, procedures, and best practices. * Meet quality, productivity, and turnaround standards associated with the department and assigned programs. * Perform other duties as assigned.     PREFERRED EXPEREINCE – Home Infusion Coordination and CPR +   QUALIFICATION REQUIREMENTS:   * Ability to communicate effectively and professionally with patients, coworkers, and clients. * Active listening, speaking, understanding, and writing English. * Ability to make decisions, solve problems, and work independently with minimal supervision.  * Ability to handle confidential and sensitive information with discretion. * Proven knowledge and complete utilization of processes, systems and techniques. * Enjoys working in a team-oriented, service-focused environment.  * Demonstrate extreme attention to detail and accuracy.  * Ability to prioritize and meet deadlines.  * Basic computer proficiency.  * Knowledge in the use of Microsoft applications.  * Proficient in using healthcare management software and systems.

The Revenue Cycle Analyst is responsible for analyzing and managing various aspects of the revenue cycle process, including billing, collections, coding, and reimbursement. This role involves ensuring accurate coding, managing claims, and identifying opportunities to enhance revenue capture. | Candidates should have at least one year of experience in revenue cycle analysis within the healthcare industry, preferably in infusion. A high school diploma or GED is required, with post-secondary education in a medical discipline highly desired. | Job Description Summary: The Revenue Cycle Analyst will play a vital role in optimizing the revenue cycle process.  This position is responsible for analyzing and managing various aspects of the revenue cycle process, including billing, collections, coding, and reimbursement.   The successful candidate will have a keen eye for detail, exceptional analytical skills, and a deep understanding of medical billing and collections.     Qualifications:        * Desired one Year experience in revenue cycle analysis within the healthcare industry, preferably in infusion.  * Minimum of a high school diploma or GED is required.    * Post-Secondary education in a medical discipline highly desired.,  * Knowledge of Windows, Word, and Excel is highly desired. * Excellent telephone and communication skills essential.  * Strong analytical skills and attention to detail * Familiarity with healthcare IT and revenue management software.  * Ability to work independently and part of a team.  * Not required but desired experience with CPR+, Caretend, Weinfuse, HcN360. * The ability to use logic as a problem-solving skill, and able to recognize trends to make decisions to improve business.       Duties and Responsibilities:   * Ensure accurate coding, charge capture, and billing practices in compliance with industry standards (i.e., CPT ICD-10, HIPAA) * Collect data from our Clients daily or weekly, to generate claims using various software platforms.  * Manage and monitor claims to maximize timely and accurate reimbursement, including claim submissions, denial management and appeals.  * Identify opportunities to enhance revenue capture, minimize revenue errors, and reduce bad debt through analysis of key performance indicators. * Analyze payer contracts, fee schedules and reimbursement to ensure proper reimbursement is made on paid claims. * Track claims that are pending due to missing or incomplete documentation (i.e.: DIF, RX, authorization, etc.). * Ensure claims are submitted promptly to insurance companies within their specified filing period.  * Regularly make follow-up calls to insurance providers to check the status of claims not settled within 30 days or their standard processing time.   * Timely submission of appeals to secure correct payment for outstanding claims * Address partial payments and denials promptly while also submitting and following up on secondary claims for resolution.  * Deliver outstanding communication to clients both verbally and in writing. * Recognize and report any issues or patterns to management as necessary. * Work claims rejected in the claim’s clearinghouse and resubmit them as required. * Ensure that notes are recorded within the client’s software platform in a clear, concise, and timely manner. * Additional duties as assigned.

Verify insurance benefits, obtain prior authorizations, follow up on status requests, and manage clinical documentation for biologic drug cases. | High school diploma or GED, 0-1 years experience with authorization processes, knowledge of medical codes and insurance benefits, strong communication and organizational skills. | As the Benefit Verification and Authorization Analyst I should be a highly self-motivated individual with exceptional organizational and communication skills. You will be responsible for daily intake verification of biologic drugs, actioning prior authorization requests, following up on status requests, and obtaining updated clinical documentation for assigned cases. The Analyst I will work to collaborate with other Analysts and bring questions to Analyst II and Supervisor for review. Qualifications: • Must have obtained a High School Diploma or GED • Minimally 0-1 years of experience or able to demonstrate expert knowledge and understanding of authorization processes. • Knowledge of CPT and ICD-10/Procedure Codes, Medical policies, LCD’s and Medical terminology. • The ability to interpret patient benefits to include deductibles, copayments, and coinsurance. • Works efficiently to ensure documentation and notification is processed in a timely manner • Professional communication both internally in work environment and externally (customer facing) • Familiarity with HCPCS, J codes and conversions is a preference • Preferred experience with home infusion, specialty therapy billing practices preferred • Preferred experience dealing with commercial and government payers • Knowledge of Microsoft Tools such as Excel, Word, office 365 experience, is a must • Analytical skills with math and clear penmanship is a must Duties and Responsibilities: • Serve as a liaison between ACU-Serve and our clients ensuring all clinical documentation is obtained to gain procedure authorizations • Work directly with Payers (Insurance) clients to perform insurance benefits verification for infusion services for assigned clients • Performs pre-certification and obtains authorizations and referrals as required by Payer guidelines • Gathers medical documentation to support the Patients' treatments for further review • Follow-up on pending referrals, pre-certifications, and/or pre-determination • Scan and upload documents from insurance providers into electronic records system and work closely with client and billing once approved • Research and follow up on authorization denials

The AIC Manager of Revenue Cycle supervises the productivity and success of full revenue cycle operations while managing day-to-day benchmarks. They oversee billing functions, ensure teams meet targeted goals, and interact with clients at a management level. | Candidates should have a minimum of 8 years of experience in billing management or supervision, with a preference for those with medical billing experience. A graduate of an accredited medical billing program and billing certification is preferred. | Duties & Responsibilities:  * Supervises the productivity and success of full revenue cycle operations  * Manages day to day benchmark of operations for revenue cycle operations  * Responsible for learning each revenue cycle system used by clients  * Participate in professional development by seeking new information and skills related to the position and generate new ideas and approaches  * Ensure and promote confidentiality of client privileged information * Oversee supervisors and ensure teams are meeting targeted goals * Produce month end #’s to CEO/executive assistant  * Oversees the billing functions, including the initiation of goals and procedures, overseeing daily operations, and coordinating office efforts to expedite payment of accounts. * Interaction/liaison as needed with our clients on management level  * Identify, implement and improved billing and collections processes that will make a positive contribution to financial results. * Prepare accurate and meaningful billing, collections, accounts receivable and bad debt reports. * Plan, organize, motivate and monitor work done by all staff under supervision * Oversee functionality and integrity of software to ensure timely and accurate administration of electronic claims, and electronic payment remittance. * Conduct yearly reviews for direct staff – keeping notes on their performance  * Weekly one on one individual meetings with your direct reports * Monthly team meetings with your team to go over issues/ideas/recommendations  * Continue education in reimbursement rules, billing rules, and coding. * Bill and Collect as needed to meet goals and expectations of the clients * Work with supervisors on metrics for the Analysts to meet monthly and monitor and enforce these goals * Conduct conference calls weekly/bi-weekly/monthly or as requested/needed by the clients * Attend yearly conferences as requested by management  * Screening, interviewing, and hiring the right candidates for open positions within the company’s budget and expectations * Performance plans, up to firing of employees * Meet month end closing deadlines  * Generate Month end reports for clients * Oversee cash team and ensure cash deadlines are being met for all accounts  * Perform Monthly audits on collectors to ensure work and collections are up to par set by the Pinnacle management team  * Work with supervisors on performance plans and mentoring employees     Qualifications and skills:  Experience with medical billing for home infusion/specialty pharmacies/DME or another area of medical billing.  Candidates should possess a roll-up-your-sleeves attitude and display a willingness to work hard and be a member of the team. Building a service-oriented practice with a positive work culture is a high priority. * Graduate of an accredited Medical Billing Program and hold billing certification preferred. * Minimum of 8 years’ experience in Billing Management/Supervision is preferred * Knowledge of Microsoft Office and proficient with spreadsheets. * Proficiency in medical terminology, HCPC and ICD 10 coding. * Proficiency in filing medical claims * Expertise in reading and interpreting EOBs * Excellent Communication Skills * Commitment to goals and Philosophy of Pinnacle Revenue Management, Inc.   * HIPAA compliance knowledge