Reimbursement Specialist - Healthcare determines the extent to which patients' insurance covers their treatments. Reviews appropriateness of CPT-4/ICD-10 coding and determines if care provided corresponds to the charges submitted. Being a Reimbursement Specialist - Healthcare ensures compliance with Federal and State regulations and company policies that govern Medicare and state payment systems. May assist in identifying fraudulent non-plan billing practices and assists the legal department with litigation preparation. Additionally, Reimbursement Specialist - Healthcare may require a bachelor's degree. Typically reports to a supervisor or manager. Typically requires Certified Professional Coder (CPC) from AAPC or AHIMA. The Reimbursement Specialist - Healthcare gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Reimbursement Specialist - Healthcare typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
Job Summary
Small privately-owned home medical equipment company looking for an experienced reimbursement specialist. Candidate must have excellent telephone skills, be highly organized and can work in a fast-paced small business environment. This position is directly involved with claim processing, appeals, verification of eligibility and benefits. This role works in tandem with others in the organization to facilitate communication regarding out of pocket expense for equipment prior to scheduling.
Responsibilities and Duties
Serve as a reimbursement resource for internal office administration and external customers(customers, payors, physicians, sales team)
Verifies coverage and benefits for new patient referrals
Reviews the patient’s medical records to obtain primary and secondary insurance payor information, and relays this to the intake department.
Manage and track all claim submissions status with payers.
Qualifications and Skills
2 years of billing experience with medical billing and/or insurance collections preferred. Proven knowledge of and experience with ICD-9, HCPCS, and modifier coding. Outstanding interpersonal, verbal, and written communications skills required. Must be flexible and able to work in a fast-paced, heavy volume work environment. Demonstrated computer, prioritization, and time management skills. Experience working at insurance companies/payors or with medical device reimbursement for a start-up or new technology company or durable medical equipment setting is high desirable.
EDUCATION/KNOWLEDGE
High school diploma or general education degree GED. Familiarity with medical device reimbursement from a manufacturer or DME perspective is preferred.
EXPERIENCE
Minimum one- year of billing experience with medical billing and/or insurance collections preferred. Proven knowledge of and experience with ICD-9, ICD-10,HCPCS, and modifier coding. Outstanding interpersonal, verbal, and written communications skills required. Must be flexible and able to work in a fast-paced, heavy volume work environment. Demonstrated computer, prioritization, and time management skills. Experience working at insurance companies/payors or with medical device reimbursement for a start-up or new technology company or durable medical equipment setting is high desirable
SKILLS
Effective written and verbal communication skills. Planning, documentation and organization skills. Able to independently problem-solve; effective multi-tasking ability; attention to detail; excellent computer and telephone skills; time management skills - ability to prioritize, ability to work in a demanding, fast-paced environment; high level of energy, motivation and flexibility. Flexibility in a start-up environment to work outside of set job responsibilities
LANGUAGE SKILLS
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write, read, and interpret routine reports and correspondence, frequently medical in nature. Ability to speak effectively over the phone and before groups of customers or employees of the organization.
MATHEMATICAL SKILLS
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Benefits
PTO, Paid Holidays, Health insurance, Dental insurance, 401k, 401k Employer Match.
Job Type: Full-time
Pay: $43,256.00 - $47,318.00 per year
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Work Location: In person
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0 Reimbursement Specialist - Healthcare jobs found in Fort Myers, FL area