Reimbursement Specialist - Healthcare jobs in Middlesex, NJ

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)

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Reimbursement Specialist
  • PROMPTCARE HOME INFUSION LLC
  • New Providence, NJ FULL_TIME
  • Description

    PromptCare is seeking a highly motivated and detail-oriented Reimbursement Specialist to join our Accounts Receivable (AR) department. The specialist will be responsible for all patient billing and collections and must be proficient in all phases of insurance data collection, verification, and authorization. The ideal candidate will have experience in healthcare reimbursement and be able to work independently in a fast-paced environment. If you are a motivated individual with a passion for healthcare reimbursement, we encourage you to apply for this exciting opportunity. To learn more about our company and services, please visit us at PromptCare In-home Respiratory and Infusion  


     Job Type: Full-time, 40hrs per week, Mon-Fri flexible schedule during the hours of 8am-5:30pm

    Location: In-Office/Hybrid in New Providence, NJ


    Requirements

    • High School Diploma or equivalent
    • 2-3 years of experience in electronic claims submission and medical collections preferred
    • Working knowledge of insurance plans including but not limited to Medicare and Medicaid preferred
    • Industry experience with billing/collections in DME, home infusion and/or enteral preferred
    • Accounts receivable and accounting experience preferred
    • Knowledge of CPR preferred


    Job Responsibilities, included but not limited to:

    • Document and input new referrals and patient admissions from start to finish 
    • Assist the PBM and Billing Specialist with issues, billing backlogs and end-of-month processes
    • Assist with collections as needed and identified in an overall weekly A/R review done by the Reimbursement Manager
    • Assist the Cash Poster as needed and identified by the Reimbursement Manager
    • Field and troubleshoot calls from patients regarding benefits, claims and patient balances
    • Pro-actively seek resolutions to any billing issues that may arise
    • Reporting/Documentation:
    • Billing documents as requested
    • Claim adjudication
    • Collection efforts and resolutions
    • Weekly status reports
    • Keeping the Infusion price table matrix up to date according to our payor contracts to ensure correct pricing in revenue.
    • Reading Claim EOB’s and correspondence for the posting of denials of non-paid claims
    • Running monthly eligibility reports and notating each patient account individually and alerting appropriate team member when necessary
    • Entering claim information when generated on Novologix website (minimal claims)
    • Other duties as assigned


    Physical Demands

    The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and listen. It also requires the ability to lift files, open filing cabinets and bend or stand as necessary. This position requires the ability to occasionally lift office products and supplies, up to 20 pounds.


    Benefits & Perks

    • Competitive Salary
    • Medical, Dental, Vision Package
    • 401(k) plan (discretionary)
    • PTO - Vacation, Sick and Personal days, and paid holidays
    • Referral bonuses & Discount Ticket Program
    • Lunch & Learn Programs
    • Employee Recognition Program

     
     

    Equal Employment Opportunity

    The PromptCare Companies is committed to Equal Employment Opportunity (EEO) and prohibits employment discrimination on the basis of race, color, age, national origin, religion, gender, gender identity, sexual orientation, pregnancy, marital status, genetic disposition, disability, veteran's status or any other characteristic or classification protected by State/Federal/Local laws. We foster a work environment in which diversity and inclusion are embraced, people are hired and advanced on their merits, and employees are treated with mutual respect and dignity.

  • 1 Month Ago

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Cosmetic Merchandiser (2023-29928)
  • Apollo Retail Specialist
  • Edison, NJ PART_TIME
  • About the JobAs a cosmetic merchandiser, you’ll take on project-based work to ensure cosmetic products, graphics, and displays are visually appealing to attract and engage shoppers, build strong relat...
  • 7 Days Ago

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Medical Assistant
  • Ankle & Foot Specialist of NJ
  • South Plainfield, NJ FULL_TIME,PART_TIME
  • Immediate opening for a friendly, well organized and efficient person for a fast growing practice. EMR experience and willing to travel to different locations is necessary. At least 2 years of experie...
  • 1 Month Ago

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Payroll Director - Pediatric Healthcare
  • Solace Pediatric Healthcare
  • Eatontown, NJ FULL_TIME
  • Solace Pediatric Healthcare is proud to be a part of the Care Options for Kids Community, the leading provider of pediatric nursing, family caregiver, school-based services, occupational, physical, sp...
  • 9 Days Ago

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Senior Accountant - Pediatric Healthcare
  • Solace Pediatric Healthcare
  • Eatontown, NJ FULL_TIME
  • Solace Pediatric Healthcare is proud to be a part of the Care Options for Kids Community, the leading provider of pediatric nursing, family caregiver, school-based services, occupational, physical, sp...
  • 9 Days Ago

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Controller - Pediatric Healthcare
  • Solace Pediatric Healthcare
  • Eatontown, NJ FULL_TIME
  • Solace Pediatric Healthcare is proud to be a part of the Care Options for Kids Community, the leading provider of pediatric nursing, family caregiver, school-based services, occupational, physical, sp...
  • 10 Days Ago

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0 Reimbursement Specialist - Healthcare jobs found in Middlesex, NJ area

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Reimbursement Specialist
  • Prompt Care Companies Inc
  • New Providence, NJ
  • Job Type Full-time Description PromptCare is seeking a highly motivated and detail-oriented Reimbursement Specialist to ...
  • 4/24/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Basking Ridge, NJ
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • North Brunswick, NJ
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Hillsborough, NJ
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Perth Amboy, NJ
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Somerset, NJ
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Westfield, NJ
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Field Reimbursement Specialist- Albany/Westchester
  • Cencora
  • New York, NY
  • Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthi...
  • 4/22/2024 12:00:00 AM

Middlesex is a borough in Middlesex County, New Jersey, United States. As of the 2010 United States Census, the borough's population was 13,635 reflecting a decline of 82 (-0.6%) from the 13,717 counted in the 2000 Census, which had in turn increased by 662 (+5.1%) from the 13,055 counted in the 1990 Census. Middlesex was incorporated as a borough by an act of the New Jersey Legislature on April 9, 1913, from portions of Piscataway Township, based on the results of a referendum held on May 6, 1913.[21] The borough's name derives from Middlesex, England.[22][23] According to the United States C...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Specialist - Healthcare jobs
$50,543 to $61,417
Middlesex, New Jersey area prices
were up 1.5% from a year ago

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