Reimbursement Coordinator – Home Infusion

This is a fully remote position, open to applicants in United States.

📋 Description

• Manage the processing of claims, posting of payments, and follow-up activities.

• Resolve discrepancies and address claims denials effectively.

• Collect billing information from clients to create claims.

• Conduct quality assurance on charges and amend claims to ensure they are submitted correctly.

• Submit claims within the timely filing periods set by each insurance company.

• Prepare and/or print secondary claims that do not automatically cross over from Medicare or other primary payers.

• Monitor pending claims closely.

• Utilize reports to determine follow-up tasks.

• Acquire claim status by contacting payers or accessing online claims status systems.

• Investigate claim payments, partial payments, and overpayments.

• Escalate claims that remain unpaid after 60 days or denied appeals for further action.

• Conduct follow-up collections on primary and secondary claims as well as assigned patient balances.

• Prepare write-off forms for identified bad debts and document the reasons for such actions.

• Perform other assigned responsibilities as needed.

⛳️ Requirements

• High School Diploma or GED is required.

• A minimum of 1-2 years of relevant experience is necessary.

• Familiarity with Medicare billing and collections is essential.

• Knowledge of home infusion or DME/POS reimbursement is preferred.

• Understanding of Medicare Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs) is important.

• Availability to work additional or irregular hours as required.

• Compliance with applicable security policies and procedures to protect company and client information is mandatory.

• Ability to sit and view a computer screen for prolonged periods is required.

• Candidates for U.S.-based positions with WellSky must be legally authorized to work in the United States.

• Proof of employment eligibility will be required upon hiring.

• Certain client-facing roles may necessitate adherence to applicable requirements, including immunizations and occupational health mandates.

🏝️ Benefits

• Comprehensive medical coverage including prescription, dental, and vision benefits.

• Access to mental health support through the Employee Assistance Program (EAP).

• Generous paid time off policy.

• 13 paid holidays per year.

• 100% vested 401(K) retirement plans.

• Educational assistance available up to $2500 annually.