Reimbursement Specialist

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

📋 Description

• Engage in the daily operations of the insurance billing process.

• Confirm patient insurance coverage and benefits.

• Ensure the prompt and precise submission of insurance claims.

• Record payments accurately.

• Conduct follow-ups on accounts receivable.

• Prepare and send appeals as necessary.

• Investigate and oversee billing issues, trends, and potential risks.

• Assess claims for accuracy and compliance with pre-claim requirements.

• Monitor claim status and generate reports, particularly in Excel.

• Analyze denied or unpaid claims and take corrective measures, including resubmissions and appeals.

• Offer administrative assistance, including data entry, record maintenance, compliance with policies and client requirements, projects, and additional administrative tasks.

• Navigate payer portals, websites, and phone systems to verify eligibility, prior authorization, and track claim and appeal statuses.

• Implement payer guidelines and policies in daily decision-making.

• Support patients throughout their financial journey.

• Validate benefits with Medicare, Medicaid, and private insurers.

• Fulfill billing responsibilities accurately and punctually each day.

• Review and interpret explanations of benefits.

• Collaborate with insurance companies, internal teams, customers, and patients with empathy and clarity.

⛳️ Requirements

• High school diploma or GED required.

• An associate's or bachelor's degree in healthcare administration, business, or a related field is preferred.

• Proficiency in personal computing, computer applications, and standard office equipment.

• Experience with Microsoft Office, particularly Word and Excel.

• A minimum of 2 years in medical billing, insurance claims, or revenue cycle operations.

• Familiarity with payer portals and claim tracking systems.

• Knowledge of HIPAA compliance and healthcare privacy regulations.

• Experience with CRMs like Salesforce and billing software such as Epic, XiFin, or Quadax.

• Strong work ethic with attention to detail and the ability to maintain a broad perspective.

• Proficient in analytical, interpersonal, communication, organizational, numerical, and time management skills.

• Excellent organizational abilities with the capacity to meet deadlines and manage multiple projects simultaneously.

• A positive attitude and an entrepreneurial mindset.

• Familiarity with ICD and HCPCS/CPT coding is preferred.

• Knowledge of the CMS 1500 claim form is preferred.

• Understanding of Claim Adjustment Reason Codes (NUCC) is preferred.

🏝️ Benefits

• Competitive salary and benefits package.

• Possible eligibility for discretionary bonuses or incentives.

• Potential for restricted stock units.

• Opportunities for career advancement and growth in a purpose-driven environment.

• Commitment to an inclusive workforce and workplace.

• Recognized as a Certified Great Place to Work in the US and Israel for 2024.