Home Infusion Medical Biller (Specialty Pharmacy)

About Us: Vive Rx Pharmacy is a fast-growing home infusion pharmacy specializing in high-cost specialty therapies including IVIG, biologics, antibiotics, and TPN. We are building a high-performance, automation-driven revenue cycle within the CareTend ecosystem—focused on reducing manual work, improving accuracy, and accelerating collections. Position Overview: We are seeking a Home Infusion Biller who can both execute at a high level and think in systems. This role is a hybrid between: A hands-on biller managing claims, follow-ups, and appeals A process builder helping refine automation, workflows, and billing logic You will play a key role in both day-to-day billing operations and building a scalable billing infrastructure. What Makes This Role Unique: Work inside an evolving CareTend automation ecosystem, including: Per diem kit billing rules tied to therapy types Automated unit calculations based on frequency (e.g., 3x/week, 14-day cycles) Structured billing templates for repeat therapies Exposure to data tracking and performance dashboards (Looker / Google Sheets) Opportunity to improve systems, not just follow them Direct impact on reducing denials and increasing collections Key Responsibilities: Billing Execution Submit and manage claims for home infusion therapies (IVIG, hydration, antibiotics, TPN, etc.) Work with HCPCS coding (J-codes, S-codes, per diems, 99601/99602) Review and validate units, NDCs, and billing structure Monitor claim status through clearinghouses and payer portals (Availity, etc.) Follow up on denials, rejections, and underpayments Prepare and submit appeals with supporting documentation Systems & Process Optimization Validate and refine automated billing logic within CareTend Identify inefficiencies in workflows and propose improvements Assist in building: Billing rules and templates Standardized claim workflows Quality control checkpoints before claim submission Collaborate with intake, pharmacy, and nursing to improve clean claim rate upstream Required Qualifications: 2+ years of home infusion or specialty pharmacy billing experience (REQUIRED) Strong understanding of: J-codes and S-codes Per diem billing structures Infusion therapy workflows Experience with claim follow-up, denials, and appeals Ability to audit claims and catch errors before submission Comfortable working in a structured, process-driven environment Preferred Qualifications: Experience with CareTend or WellSky CPR+ Experience billing: IVIG, TPN, hydration, biologics Familiarity with: Automated billing rules or templated workflows Reporting tools (Excel, Google Sheets, Looker) Experience with out-of-network billing and repricing (Zelis, Multiplan) What Success Looks Like: Claims submitted accurately within 14 days of date of service Reduction in denials and rework Increased collections and faster payment turnaround Meaningful contributions to automation and workflow improvements Ability to spot patterns and fix root causes—not just symptoms Pay: $25.52 - $30.73 per hour Expected hours: 80.0 per week Benefits: 401(k) Dental insurance Flexible schedule Health insurance Paid time off Vision insurance Experience: Medical billing: 1 year (Preferred) Home infusion billing: 1 year (Preferred) Work Location: In person