Reimbursement Specialist - Healthcare jobs in Sacramento, CA

We are growing! Active Life Medical Products Inc. is a Durable Medical Equipment and Disposable Medical Supply provider. We are looking for dynamic and reliable customers service-oriented team members that have a passion for delivering the best service and making a difference in the lives of others!

The Reimbursement Specialist is a requires excellent communication skills, independent judgment, and ability to interact with private, state, and federal payer representatives, fiscal intermediaries, and case managers in the role of coordinating reimbursement from product dispensing through to completion and final resolution of the payment cycle.

Responsibilities:

Along with the specified job duties listed below, the position is required to maintain strict adherence to all Active Life Medical policies and procedures as published, and as amended from time to time. This adherence applies to all compliance and performance plans, policies, code of conduct, laws, and regulations in effect.

• Submit and/or follow-up on payer claims. This may include primary, secondary, tertiary claims and/or patient statements. Verify accuracy of payments according to the payer’s fee schedule.
• Possess a basic understanding and ability to audit accounts receivables: analysis of payments, contractual discounts and/or adjustments, bad debt, recoupments, refunds and the credit/debit function.
• Draft professional, concise cover letters, appeals and correspondence. This may include provider dispute forms, re-openings, reconsiderations, and various levels of appeals as necessary during the collection process.
• Resolution of credit balances. This may include revenue adjustments, balance transfers, recoupments and/or refunds.
• Clearly and accurately document all collection efforts within the AR system. Complete and submit monthly claim status reports.
• Promptly inform management of reimbursement rates, changes, and/or issues which may directly affect The Companies® receivables.
• Maintain reimbursement records in compliance with The Companies® policies & procedures.
• Attend and participate in departmental meetings. Continuously strive to improve processes and service quality to internal and external customers.
• Attend pertinent job-related trainings and educational seminars.

Qualifications:

To perform this job successfully, the individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience: High school diploma or equivalent is required. Knowledge of medical terminology and medical insurance plans and benefits preferred. Minimum of two-years relevant work experience in similar responsibility required. Experiential requirements may be waived in lieu of evidence of progressive growth in and attainment of the skills necessary to perform the required duties.

Language Skills: Must speak fluent English. Must possess strong written and verbal communication skills· Ability to communicate information about claim Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Computer Skills: Mid-level computer proficiency is necessary. Proficiency utilizing Excel required. Brightree software.

Work Remotely

• No

Job Type: Full-time

Pay: $20.00 - $24.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work Location: In person