Reimbursement Specialist

See your work in a new light.

At LUX Infusion, we're reimagining infusion care to be more human, supportive, and connected. Inspired by lux—meaning light - we guide patients, providers, and partners through complex therapies with clarity, compassion, and confidence.

As a clinician-led, U.S.-based organization, we put people first - helping patients feel seen and supported through faster therapy starts, dedicated care coordination, and meaningful collaboration. Our commitment to inclusion, diversity, equity, and advancement (IDEA) is central to our culture, ensuring every team member feels valued and empowered to make a difference.

Compensation:

Up To $27.00 Per Hour Based Upon Experience

Final compensation offer to candidate may vary based upon work experience, education, and/or skill level.

Schedule & Location:

8:30 am -5:00 pm CST or EST on site in Overland Park, KS or Garnet Valley, PA. Work location is subject to change based on business needs.

Job Description:

The Reimbursement Specialist is responsible for the accurate and timely billing and reimbursement of claims.

QUALIFICATION REQUIREMENTS

• High School Diploma or GED required
• Minimum of two (2) years of medical insurance experience required
• Basic computer and internet skills (e.g. Microsoft Office)
• Strong customer service skills, focus and dedication.
• Commitment to excellent customer service and professionalism to resolve complex payer coverage issues

QUALIFICATIONS PREFERRED

• Minimum of two (2) years of home infusion experience preferred
• Prior experience with CPR+ and/or CareTend preferred
• Certified Pharmacy Technician/License preferred, but not required

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Billing Responsibilities

• Submits accurate claims to primary and secondary insurers and resubmits accurate corrected and rejected claims in a timely manner.
• Acquires necessary authorizations and current eligibility information from insurance company for the dispense prior to release of delivery; communicates findings with pharmacy prior to delivery; documents notes in system.
• Maintains patient files with pertinent information required by insurance companies (CMN, rxs, medical records, etc.).
• Prior to submitting claims, confirms that orders have been delivered verifying date of delivery.
• Invoices patients for patient responsibility amounts (co-pay, deductible, out-of-pocket, etc.).
• Communicates with field staff as needed (new referrals, signed tickets).
• Responsible for billing audits both internally and externally.

Collections Responsibilities

• Tracks each claim on a weekly basis; maintains A-R Manager report in Excel and updates each outstanding claim with a status detail note, includes insurance company's reference number; submits report to the Director of Revenue Cycle Management; updates the claim's billing note in CPR+ with the status detail note.
• Predicts cash flow from claim's progress through insurance system.
• Maintains documents showing proof of communique with insurance companies, providers, etc. (i.e. email printouts, fax confirmations, FedEx tracking).
• Tracks incoming checks for receipt; if issued to patient, communicates with patient or RCC to collect monies.
• Responds to insurance requests in a timely manner (medical records, rxs, CMNs, etc.)
• Makes bank deposit and maintains accurate monthly deposit report, as needed.

Insurance Responsibilities

• Verifies new patient referral information with insurance company, reports findings to Director of Revenue Cycle Management via insurance verification form
• Completes insurance company contracts and/or necessary forms to maintain or become a provider.
• Reports unusual events or trends related to claims or insurance industry to Director of Revenue Cycle Management.
• Assists in insurance audits by providing all necessary billing paperwork in a timely manner.
• Proactively improves understanding of bleeding disorders, products and treatments; stays current on legislative changes and insurance coverages, and is capable of disseminating this information to employees, patients and others within the bleeding disorder community.
• Participation in QMC Quarterly Meetings, as needed.
• Participates in orientation, education, training programs, CE's, literature reviews and other materials, as assigned.
• Completes all competence/skills billing assessments as required.
• Provides courteous, cooperative and timely service to patients, visitors, and staff.
• Participates in quality assurance activities and audits, as directed.

KNOWLEDEGE, SKILLS AND ABILITIES REQUIREMENTS

• Ability to maintain competence for current position.
• Ability to maintain accurate records and prepare reports and correspondence related to the work.
• Ability to perform work within specified time frames and adapt positively to frequent interruptions and changes in workload and/or work schedule.
• Strong customer service skills, focus and dedication.
• Excellent interpersonal and organizational skills.
• Ability to set priorities and solve problems.
• Excellent verbal, written, and communication skills.
• Ability to respond quickly to emergency requests.
• Self-motivated, self-reliant and team oriented.

Communication Skills

• Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.
• Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.

Computer Skills

• Become and remain proficient is all programs necessary for execution of the position.

PHYSICAL DEMANDS

The physical demands described here represent those required for an employee to successfully perform the essential functions of this role. Reasonable accommodations may be made to enable individuals with disabilities to perform these functions. If you require a reasonable accommodation during the application or interview process, please contact the LUX Infusion Talent Team at [email protected] or 954.385.7322 x 1425 .

While performing the duties of this position, the employee may occasionally be required to stand, walk, or sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch, or crawl; and talk or hear. The employee may also be required to occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this role include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

OTHER REQUIREMENTS

Employees are expected to:

• Participate annually in required legal and ethical compliance training
• Consistently act in compliance with LUX Infusion's legal, ethical, and compliance policies
• Adhere to all standards and procedures outlined in the LUX Infusion Compliance Manual
• Refrain from any behavior that could be considered unethical or unlawful

EXPECTATIONS FOR ALL EMPLOYEES

All LUX Infusion team members are expected to support the organization's mission, vision, and values by demonstrating integrity, dedication, compassion, and enthusiasm. This includes placing patients first, working collaboratively with a "stacked‑hands" mindset, and maintaining a consistent focus on quality, accountability, and continuous improvement.

GENERAL INFORMATION

The statements above are intended to describe the general nature and level of work performed by individuals in this role. They are not intended to be an exhaustive list of all responsibilities, duties, or skills required.

This role operates in a fast‑paced environment and requires the ability to prioritize competing demands, manage multiple tasks effectively, and seek guidance when appropriate.

Employees in this position may be required to assist directly - or coordinate appropriate assistance - to ensure access to LUX Infusion's services for individuals with disabilities, including patients, visitors, employees, or others.

LUX Infusion is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by law.